Jack Straw: We continue to make strong representations both directly to the Israeli Government—I keep doing that—and to the Government of the United States, the Government with the most influence in the world over the Israeli Government.
	The sooner we reach final-status negotiations, the easier it will be to resolve the issue of the wall. The Israelis say that they are ready to shift the wall, as they shifted an earlier line of control in the Lebanon, as soon as there is political agreement on the borders between the new state of Palestine and the state of Israel. Those issues are to be resolved in the final-status negotiations. My reply to the Israelis is that while in one sense shifting a wall is straightforward, it would be profoundly objectionable for settlements to be built within the wall to pre-empt any shifting of it later.

Kelvin Hopkins: Given the reality that the constitution is as dead as the Monty Python parrot, would it not be better for Britain to propose a more sensible alternative—the idea that, in future, Europe should be an association of independent, democratic states responsible for their own internal affairs—[Hon. Members: "Hear, hear."]—co-operating only where there is mutual benefit to be gained?

Adrian Bailey: I welcome my hon. Friend's comments about the reduction in export subsidies from the EU, but will he stress—not only with the EU, but with other countries—that the huge potential benefits to be gained from the cancellation of world debt for developing countries could be undermined unless the developed world recognises the need to reduce export subsidies that undermine the economies of those countries?

Douglas Alexander: I take my hon. Friend's point. We have always seen the opportunity of 2005 as being to align the progress that was made in June, when European Ministers agreed effectively to double bilateral overseas development assistance from the European Union, with the decisions reached by Finance Ministers—confirmed at Gleneagles in July—on the significant multilateral debt relief that my hon. Friend mentions. The third element of the trinity was the need to try to make real progress in Hong Kong. All of us recognise that if we have the right outcome in Hong Kong and when the round is concluded, it will offer the opportunity not only for more jobs and prosperity in the European Union but will be fairer for the developing world.

Douglas Alexander: A range of issues are related to the hon. Lady's question. First, on sugar, fundamental reform was agreed last week, thanks to my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs. There is ongoing consideration as to what level of support can be provided directly during a longer transitional period than was initially envisaged.
	Secondly, there is the issue of economic partnership agreements. Before the European presidency, the British Government set out a position that, I am glad to say, has found favour not just with NGOs in the United Kingdom but with other countries that are affected by changes such as those of which the hon. Lady speaks; but we need to continue to work, as the British Government, during the British presidency to make these cases to our European partners. That is why, when my right hon. Friend the Foreign Secretary chaired a meeting on trade talks, I took the opportunity to make the case to other European partners that if we got this round right there was an opportunity to be both pro-jobs in Europe and pro-poor in the world—and that, particularly in relation to the sugar and banana regimes, a successful outcome would provide considerable gains not just to those individual countries but to us all.

Tom Clarke: Given the Government's laudable commitment to millennium development goal 8, does my hon. Friend agree that the issue of trade far transcends even crucial matters such as aid and debt; that the European Union can indeed exercise a substantial role, coupled with the United States; and that, on these matters, transparency would indeed be welcome?

Douglas Alexander: My right hon. Friend makes an important point. It is hard to overstate the contribution that trade can make to the fulfilment not just of the millennium development goals but of those countries' potential. That point was driven home to me recently when I was reading speeches made by President John F. Kennedy during his term in office in the United States, when he spoke at the beginning of one trade round of the potential of helping developing countries such as Japan. If one looks around the world, one realises that it is hard to find an example of a country that has managed to lift its population out of poverty other than by having an open trading system. That is why we regard the potential of Hong Kong as being to take forward the work that we have begun during 2005, but I fully accept the point that my right hon. Friend makes that it is a vital and very significant element in that trinity of increased development assistance, reduced debt payments from developing countries, and, of course, the fairer trade system that I know he favours.

Norman Baker: The Minister will be aware that St. Helena has an unique environment—indeed, Charles Darwin referred to the "unique flora" on the island—and that therefore the proposal to build an airport is highly controversial on the island. Does he agree that before any airport is built there should be a full environmental impact assessment, which should conclude that the flora and fauna of the island will be properly protected? If so, can he explain why Clive Warren, the Department for International Development's head of overseas territories, told a public meeting in St. Helena on 26 April that
	"the airport will happen, come what may"?
	Is that the Government's position?

Ian Pearson: I can assure the hon. Gentleman that there will be a full and rigorous environmental impact assessment. That is ongoing and there has been extensive public consultation as a result of the inquiry.
	We are not rushing headlong into anything. The first environmental analysis of airport options was carried out in 1999, and further environmental scoping studies were conducted in 2001 and 2004. We want to ensure that we can bring an airport to the island, but we want to do it in a sustainable way that does not damage the environment, and we shall continue to press forward with that objective in mind.

Jack Straw: I am grateful for what the hon. Gentleman said, overall. However, all organisations operating in the United Kingdom must do so within the law. Some organisations, including those that he mentioned, are kept under close scrutiny by law enforcement agencies. If there is any evidence that they are transgressing and they thus become candidates for proscription under the Terrorism Act 2000, my right hon. Friend the Home Secretary examines that evidence with great care. These are not just the usual warm words because the matter is kept under continuous review.

Jack Straw: I am pleased to tell my hon. Friend that there has been increasing co-operation in recent months with India, Russia and China in respect of the Iran dossier before the IAEA board of governors. India helpfully voted with the E3 in the board of governors on 24 September, which meant that there was a significant majority, rather than a bare majority, when Iran was declared as non-compliant with its safeguards agreement under the non-proliferation treaty. We have been involved in intensive discussions with the Russian and Chinese Governments—at Head of State and Government level, as well as Foreign Minister and senior official level—and I believe that they are likely to bear significant fruit.
	One of my concerns during the long-running saga inside the board of governors with my French and German colleagues on the Iran dossier has been to try to maintain effective international cohesion and solidarity because that is the surest way in which we can bear down on those in Iran who are trying to use the nuclear power programme to develop nuclear weapons. If we are divided, we will end up in a position in which there are far too many opportunities for those in Iran to exploit the situation. That is why we work with such care. If and when we need to take tough decisions in the IAEA board of governors, I hope that India, China and Russia will actively support us.

Jack Straw: It is my working belief that Iran is at the very least developing the options for a nuclear weapons programme. Given the beliefs that we had on the basis of some published information and some intelligence on Iraq, we have to look at the evidence with great caution and care. The evidence, which originally came from a document from the AQ Khan Research Laboratories in Pakistan, tells us that the Iranians had in their possession information that could lead to the development of the hemispheres, which for certain have no purpose other than the development of nuclear weapons. What the evidence does not tell us for certain is what Iran intended to do with that. It is a piece of circumstantial evidence and we need to treat it as such. It is not incontrovertible evidence—it is not a smoking gun—that makes us certain that Iran has a nuclear weapon.

Jack Straw: There have been a lot of discussions with the Russians at Foreign Minister level. I was also present at a detailed discussion on Iran between President Putin and our Prime Minister when the President was here a few weeks ago, and there have been many other discussions. I do not recall that comment by President Putin. I certainly recall his comments that he would be opposed to Iran developing a nuclear weapon. The Russians are very alive to the significant risks that would apply if Iran developed a nuclear weapon because it could destabilise not only the middle east, but the southern republics of the Russian Federation. It would be a serious development.
	Russia is involved in the Bushehr refinery and in agreeing to supply the Iranians with a nuclear power plant lock, stock and barrel, including the fuel. There are separate discussions on whether Russia, under international supervision, would be willing to enrich the uranium, which is converted in another facility in Iran. We are discussing that with the Russian Federation. It may be one way to provide what the Paris agreement described as the objective guarantees, which we are all seeking, that Iran's nuclear programme is entirely peaceful in its purpose.

Joan Ruddock: Despite reservations about my right hon. Friend's protests, will he repeat such protests, particularly about Bethlehem, as the opening of the new crossing at Rachel's tomb is an abomination. That district is deep inside Palestinian territory, and there is no justification for choking off its tourism industry and economy. In the run-up to Christmas, it is particularly important that reassurances are given and that my right hon. Friend supports, I hope, the "Open Bethlehem" initiative.

Michael Fabricant: Is it not the case that there would be no need for a defensive fence if terrorist attacks on the state of Israel did not take place? With that in mind, what steps are the Government taking to ensure that countries such as Syria, Iran and perhaps even elements in Saudi Arabia who pay what some call protection money do not support terrorist organisations that attack Israel through that fence?

Jack Straw: First, it is legitimate for any state to erect a security wall to defend its citizens. The issue is not whether Israel is entitled to a security wall—the issue is the route. The objection is not about where it goes on Israeli land but on Palestinian land—let us make that clear. Secondly, I have made very, very strong representations to the Government of Iran and particularly to the Government of Syria, both privately and very publicly in the Security Council, to pressure Syria to do what it says it is doing but what, frankly, it has not done until now—force Hamas, Islamic Jihad and Hezbollah to wind up all the activities that operate out of its territories. As for Saudi Arabia, I am not aware of any provenance for the hon. Gentleman's statement. These days, however, the Government of the Kingdom of Saudi Arabia are strongly opposed to any terrorist activity anywhere across the middle east.

David Heathcoat-Amory: Among all the confused drift of the Government's European policy, at least they have been consistent about their promise not to give up the British rebate, which limits our contributions to the EU budget to about £3.5 billion a year. Does the hon. Gentleman remember the Prime Minister at that Dispatch Box on 8 June saying:
	"The UK rebate will remain and we will not negotiate it away. Period."—[Official Report, 8 June 2005; Vol. 434, c. 1234.]?
	But in view of the earlier remarks by the Foreign Secretary which referred to the so-called anomaly of the rebate, was that earlier promise by the Prime Minister worthless?

Philip Davies: On point of order, Mr. Speaker. On 17 October, when I asked the Minister of State, Ministry of Defence if there were likely to be any advances on the £87 million cost increase in the troubled landing ships dock (auxiliary) contract with Swan Hunter, the Minister said:
	"All that the hon. Gentleman has done is recite figures that we have already reported to the House in previous answers. To ensure the delivery of the ships from Swan Hunter, we amended the contract arrangements."—[Official Report, 17 October 2005; vol. 437, c. 624.]
	Yet on 3 November, in a written answer to my hon. Friend the Member for Aldershot (Mr. Howarth), the Minister stated:
	"Both companies have indicated likely cost increases to their programmes"—[Official Report, 3 November 2005; vol. 438, c. 1264W.]
	The answer also revealed a further £62 million payment to Swan Hunter, which had yet to be revealed to Parliament. Following that, my hon. Friend learned that the Ministry of Defence learned about that in June. So why, when the Minister learned of these further cost increases in June, did he not indicate when asked by me directly on 17 October that further cost increases were expected? Will you ask the Minister to come to the House and correct that misleading statement?

Edward Garnier: On a point of order, Mr. Speaker. You will recall that considerable disquiet was expressed on both sides of the House at last Thursday's business questions about the cancellation of the debate on police restructuring. Today, we had a one-and-a-half hour debate in Westminster Hall, which we are extremely grateful to you for granting to the hon. Member for Stockton, North (Frank Cook). Unfortunately, only six hon. Members were able to get into that debate—I am not making a special plea, but I reduced my contribution to two minutes to allow others to participate. [Interruption.] It was hugely appreciated.
	During her closing remarks, the Minister for Policing, Security and Community Safety implied that the Government have already made up their mind about the restructuring of the police service. We all know that the expression, "Government consultation", is an oxymoron, but the Government should at least do the House the courtesy of discussing the matter on the Floor of the House and, I submit, they should do so in response to a substantive motion, so that all hon. Members affected—all those who represent English or Welsh constituencies—can properly discuss and bring to the House their constituency and area concerns.
	My concern is that the Home Secretary and his junior Ministers are riding roughshod over the rights of this House. They refuse to have a debate because they do not want to have a debate; they are trying to box us into short debates in Westminster Hall, which are not adequate fully to discuss the issues; or they want to postpone the matter until the new year, because the consultation period finishes on 23 December, when the matter will be dead, so far as they are concerned. Will you invite the Home Secretary, in the reasonable way in which I have addressed you, to come to this House and explain himself, otherwise the Home Secretary will let down himself and this House?

Mark Harper: It is worrying that the hon. Member for Bristol, West (Stephen Williams) drew a parallel between smoking and voting. If the Labour party get their hands on it, it will be banning voting just as it wants to ban smoking.
	The Electoral Commission is investigating national voting at 16 at great length. Its report, which was published in April this year, concluded that the minimum age for all levels of voting in UK public elections should remain at 18, although it said that the minimum age for candidacy should be reduced to 18. I welcome the latter move, and that has been put forward by the Government in the Electoral Administration Bill. My party and I support that. Having candidates aged 18 would be valuable.
	In its report on reducing the voting age, the commission, which conducted wide-ranging public consultation, concluded:
	"On the little hard evidence available, it would appear that overall turnout would almost certainly drop in the short-term as a result of lowering the voting age and the longer-term effects on turnout are disputed."
	It also said that
	"lowering of the voting . . . age was unlikely to have as significant an effect as the much more fundamental cultural shift required in how young people are engaged in the wider political process."
	In my constituency, Speech House—the home of debate—was host to much discussion on this subject when Forest sixth-formers met during local democracy week in the Verderers' court. The Royal Forest of Dean college, Wyedean school and Newent community schools sent students to debate whether the minimum age of voting should be lowered to 16. Even among an audience made up entirely of 16 to 18-year-olds, there was almost a 50:50 split. Even among the target age group there is not a clear wish for change.
	The hon. Member for Bristol, West said that there are a number of things that young people are permitted to do at 16, but he did not give the full picture. It is true that someone can join the Army at 16, but that person cannot serve on the front line until 18. It is true that we can get married at 16, but until 18 people have to have their parents' permission. We make distinctions in this country and there are certain things that can be done only when someone achieves the age of majority, when he or she is deemed to be an adult. A line must be drawn somewhere. If we move to 16, no doubt there will be arguments to move the age even further. Without a clear line there is no obvious end.
	The Electoral Commission conducted a wide-ranging survey that involved ICM. In an unprompted survey, 64 per cent. of the public said that 18 was the correct age. Only 18 per cent. thought that 16 years was preferable. When given a choice between 18 and 16, 78 per cent. said that 18 was the correct age. Interestingly, those below the age of 18 wanted the voting age to be lowered, but once they had reached the age of 18, they expressed overwhelming support for the 18 limit.
	The Electoral Commission's survey, conducted by ICM, came up with some solid conclusions. It stated:
	"These results represent a solid affirmation of the status quo. There may be valid reasons for reducing the voting age"—
	the hon. Member for Bristol, West has outlined some that he found convincing—
	"but the general public are . . . unimpressed by them. Indeed, a reduction in the voting age could only be justified . . . by attaching more importance to the wishes of current 16–17 year olds than to the views of the public at large".
	It went on to say:
	"Rarely does a research survey produce a truly remarkable statistic."
	We have to draw the line somewhere, and traditionally we have set 18 as the age at which one becomes an adult. That is a sensible settlement. It is sensible to reduce the age of candidacy to parallel the voting age, but this measure does not deserve the support of the House.

Patricia Hewitt: I beg to move, That the Bill be now read a Second time.
	I am proud to introduce a Bill that is a landmark in the protection of public health and the improvement of our health services. It does three key things. It gives us power to ban smoking in enclosed public places and workplaces, it strengthens our hand in the battle against methicillin-resistant Staphylococcus aureus and other hospital infections, and it contains a series of measures that will strengthen control of dangerous drugs, improve pharmaceutical and ophthalmic services and help to deal with fraud in the national health service.
	I realise that the House may be particularly interested in the provisions on smoking, but I want to make a few brief points about other aspects of the Bill first to ensure that they are given due attention. The first commandment of the medical profession is "Do no harm". Unfortunately, as we all know, there are occasions when patients are harmed, not healed, by their hospitals. It is not surprising that MRSA and other health care-associated infections are of great concern to members of the public, particularly if someone in the family or neighbourhood has suffered from them. Part 2 of the Bill—clauses 13 to 15—gives us stronger powers to reduce MRSA and other infections to the absolute minimum.
	We were the first Government to require surveillance for MRSA, and we are already using the information to help drive down infection rates. We set a target of no later than 2008 for the halving of MRSA infections. Indeed, some of our specialist hospitals such as Guy's and St. Thomas', which treat some of the most complex cases in the country, and in early 2004 had among the highest MRSA rates, had already nearly halved their infection rates a year later.
	The Bill builds on the work that we are already doing; it provides for a legally binding code of practice on health care-associated infections, which will apply to any relevant NHS body. The code will be based on existing best practice, and a draft on which we consulted earlier this year was well received. It will be backed up by new duties for the Healthcare Commission to ensure that it is observed, including the power to serve an improvement notice.

Andrew Lansley: The Secretary of State does not have to give way to me, so I am grateful to her for doing so again—but does she not recall that two weeks ago I presented to the House data that showed that although in 2000 the NHS started with 186,000 beds, with a target of 7,000 additional beds, the number went down by 4,000? On present indications, we estimate that this year, as a result of NHS deficits, the number is likely to reduce by another 2,500, so there will be fewer than 180,000 beds. The number of beds is going down, and bed occupancy rates are persistently far higher than the Government said they would be when they responded to the NAO five years ago.

Mark Pritchard: Does the Secretary of State agree that the Government can have all the codes that they want to try and tackle ESBL—extended-spectrum-lactamases; VRSA—vancomycin-resistant Staphylococcus aureus; MRSA and all the superbugs, but if primary care workers are unable to obtain flu jabs this winter, patients will be put at direct risk. In my constituency, primary care workers are unable to have flu jabs, putting my constituents at risk.

Patricia Hewitt: My hon. Friend has raised early in this debate what the exemptions should be, but I would refer him first to the manifesto on which he and I were both elected earlier this year. [Interruption.] Perhaps I may just finish this sentence, which is rather an important one, if I may say so, for all my hon. and right hon. Friends. We were all re-elected this year on a manifesto that promised we would legislate to ensure that
	"all enclosed public places and work places other than licensed premises will be smoke-free . . . that all restaurants will be smoke-free, all pubs and bars preparing and serving food will be smoke-free".
	The Bill delivers on that promise by introducing a complete ban on smoking in enclosed public spaces and workplaces, but allowing for limited exemptions about which I shall say something more in a moment.

Patricia Hewitt: My hon. Friend makes an extremely important point. The prevalence of smoking in England and other parts of the country is going down among all groups, including working-class men. Indeed, the evidence on young women is not as clear cut as he suggests. Smoking rates are going down. They are going down even faster among better-off groups. Of course, we need to do more on smoking cessation programmes, in particular, alongside the Bill.
	The Bill is an enormous step forward for public health. It will help to reduce the number of people smoking by a further 500,000 to 750,000 over time. It will help to reduce the number of deaths of people in the work force that are associated with second-hand smoke, which is estimated at some 500 to 600 a year.
	When framing the legislation—this was the point of many debates and the public consultation that took place before the publication of the "Choosing Health" White Paper and, indeed, the election—we are striking a balance between two extremes: on the one hand, an over-prescriptive state; and on the other, which is represented by Conservative Members, an irresponsibly laissez-faire Government. We are responding to the clear wish of the public to be protected from other people's smoking in public places, especially restaurants, on the one hand, and on the other hand allowing people who want to have a cigarette with a drink to do so.

Paul Burstow: Will the Secretary of State explain how she came to the balance that she has struck and, in particular, why she appears not to have taken into account her regulatory impact assessment? It compares a comprehensive ban with a partial ban and shows that more than 200 additional people a year will die from second-hand smoking if we stick with a partial ban. Is not it the case that more people will die if we do not go for a comprehensive measure?

Louise Ellman: Is the Secretary of State aware that the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for St. Helens, South (Mr. Woodward), informed smoke-free Liverpool that the main reason that he wanted a total ban on smoking in Northern Ireland was that he did not want two classes of workers—people exposed to smoke and people not exposed to smoke? If that is good enough for Northern Ireland, why is it not good enough for workers and employees in this country?

Patricia Hewitt: I am most grateful, Mr. Deputy Speaker. Indeed, I said that the Northern Ireland Assembly was suspended but that we were proceeding in the spirit of devolution.
	In making our judgment about licensed premises, we have taken into account the fact that England already has the lowest smoking rates in the United Kingdom. Our smoking rates have fallen faster and to a lower level than is the case in Wales, Scotland and Northern Ireland. We have also taken account of the tension in public attitudes. I referred earlier to the extensive public consultation that we conducted before publishing the "Choosing Health" White Paper. It demonstrated enormous support for a ban on smoking in restaurants and pubs where meals are served. People clearly want to be able to enjoy their meal without someone blowing smoke over their food and into their face. Similarly, people want an extensive ban in most enclosed public spaces, but when they are asked about membership clubs and pubs that do not serve food, most of those who do not smoke—the majority—believe that smokers, even though they are a minority, should none the less have some freedom of choice. They clearly view membership clubs as private clubs run by members for members. Such clubs have always been treated differently from other licensed premises because they are non-profit-making organisations.

Andrew Lansley: I am grateful to the Secretary of State for giving way. Given that we are debating a public health measure and that the public may take the view that we should not interfere with smokers' right to continue smoking among smokers, where is the public health evidence that suggests that the impact of second-hand smoke differs according to whether one is in premises where food is consumed, as distinct from other premises? What is the evidence relating food to second-hand smoke?

Andrew Lansley: I hope that the hon. Gentleman will have the opportunity to speak later when he can explain what he means by that last comment. I am not an apologist for the tobacco industry. I was simply pointing out that the reduction in the prevalence of smoking was faster in the 1980s. He knows that—I attended the conference that he chaired on the battle against cancer. There has been a long-term reduction in, for example, lung cancer mortality but there are worrying indications. It was wisely noted earlier that difficulties remain with the prevalence of smoking in elements of population. That is especially true of working-class communities and young women. Smoking by young people has barely reduced in the past five years. He knows from the statistics that were presented to his conference of the all-party parliamentary group on cancer last Thursday that not only has the incidence of lung cancer mortality in young women risen, but overall mortality rates for women are not reducing compared with the substantial reductions in men.

Andrew Lansley: Before the election, we made it clear in a document that was published in February that we believe that individuals are primarily responsible for their health. Indeed, the Secretary of State made more or less the same point. We therefore want to proceed when possible through voluntary measures and self-regulatory solutions rather than legislative ones.
	If I am to disappoint Labour Members, I will disappoint some of my colleagues, too. As we made clear before the election, we would have included provisions in a public health Bill to enforce a reduction in smoking in circumstances in which a self-regulatory solution had not been effective in three years. We did not propose a comprehensive ban. We proposed that, first, wherever non-smokers had access—including licensed premises as well as workplaces—they should not be exposed to second-hand smoke. That is different from private houses and private clubs. Secondly, wherever children had access, they should not be exposed to second-hand smoke. Thirdly—again reflecting a point similar to one that the Secretary of State made—workers in the hospitality industry, such as people who work behind a bar, should not be exposed to second-hand smoke.
	Although not a comprehensive ban, our proposals bore a close resemblance to those that the Secretary of State reportedly pressed on her Cabinet colleagues before the publication of the Bill but was prevented from implementing. The proposals that we are discussing are not those that Secretary of State wanted to introduce.

Andrew Lansley: No. I shall carry on because I want to get the evidence on the record. Curiously, the Secretary of State did not get the evidence on the record. I remind my right hon. and hon. Friends that it is not acceptable for us not to make progress. That was at the heart of what we were proposing at the election. We must make progress towards smoke-free environments because the evidence of health effects is increasingly strong.
	The Scientific Committee on Tobacco and Health set out the evidence straightforwardly. The increase in the risk of lung cancer among non-smoking partners of smokers is about 24 per cent. for women. For non-smoking men who are partners of smokers, there is about a 37 per cent. increase in risk. For those who have workplace exposure, there is an 11 per cent. increase It estimates a 25 per cent. increase in risk of coronary heart disease resulting from exposure to second-hand smoke. Insufficient attention has been drawn to this, but what has become most interesting most recently is the significant increase in the risk of coronary heart disease associated with small increases in exposure to second-hand smoke. I shall read the relevant extract from the committee's report:
	"The increased risk associated with exposure to SHS"—
	for coronary heart disease, it is about 25 per cent.—
	"is . . . a substantial fraction of the risk from active smoking, although uptake of smoke by non-smokers is typically only about 1 per cent. of that by active smokers. Thus it appears that substantial risk arises from quite modest exposure to SHS."
	That is the most important extract from the updated advice of the scientific committee. There is not a linear relationship between dose and risk; if anything, there is a non-linear relationship that shows substantial risks associated with modest exposure.

Andrew Lansley: I am grateful to my hon. Friend for that intervention. The essence of our proposals would have made it possible for non-smokers to be in a smoke-free environment. They would also have made it possible for smokers to continue to be in smoke-filled environments—[Interruption.] The Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint) asks how from a sedentary position. It is actually rather similar to what her right hon. Friend was proposing, that is, if a public house can segregate smokers in smoking rooms, it would be able to allow smoking. If it could not, smoking would not be allowed. A public house is open to the public, but it would not be allowed to invite people in if they were likely to be exposed to second-hand smoke against their wishes.

Greg Hands: I want to return to my hon. Friend's earlier point about children. Tomorrow, in the House, I shall launch children's cancer awareness month for CLIC Sergeant, and that is an important issue. However, I want to raise exemptions on behalf of a company in my constituency. Does my hon. Friend agree that there should be an exemption under clause 3 for certain workplaces involved in the tobacco trade? A business in my constituency, Hunters and Frankau, is a specialist importer of cigars, but under the Bill, it will not be able to test its products on its premises. The business is located in one of Britain's most deprived wards. [Interruption.] Labour Members may well talk among themselves, but there was a majority for the governing party of only three votes in that ward. That company also imports products from some of the world's most deprived countries, including Cuba. Is it not therefore unreasonable that it should be banned from testing its products on site?

Andrew Lansley: I am happy to confess to my right hon. Friend that I do not know, and perhaps the House does not yet know. I stand to be corrected if the necessary regulations have come forward in relation to Northern Ireland to make that clear. The issue arises not only in relation to prisons but some care homes and mental health institutions.

Steve Webb: I follow the hon. Gentleman's logic about health inequalities being exacerbated by the Government's approach, but does that not also apply to his own desire to keep the exemption for private members clubs? Are they not too concentrated in less privileged places?

Andrew Lansley: Actually, I am with the hon. Gentleman. I said that we had three objectives, the first of which was that non-smokers should not be exposed to second-hand smoke. The second applies wherever children are present, so if a private members club wants to admit children, it should have to choose whether to do that or whether to allow second-hand smoke. It should not be able to do both.
	I want to speak about other aspects of the Bill as well as smoking, so I shall finish talking about this issue now. The Government know perfectly well not only that there is no evidence to support their supposition, but that 90 per cent. of the 57,000 responses to the consultation opposed their partial ban and wanted something more comprehensive, in many cases, or something more voluntary, in other cases. People on both sides of the argument regard the Government's proposal as the worst outcome. Astonishingly, when appearing before the Health Committee last week, even the chief medical officer made it clear that in terms of health inequalities this is the worst outcome—worse than no ban at all.

Andrew Lansley: I thought that I did go on to say that most people said that, although some who opposed the Government's proposal wanted a more voluntary approach. However, that is not the point. The point is that people on both sides of the argument do not see any merit in the Government's proposals.
	It is for that reason, and considering the range of views in the House, that my right hon. and hon. Friends have agreed to have a free vote on this issue. This is a genuine issue of judgment, which Members of Parliament are perfectly capable of dealing with, and it is not proper to use whipping to try to constrain people to exercise their judgment contrary to their conscience. The official Opposition will have a free vote, and I hope that the Secretary of State will take the opportunity to say that she has thought hard and concluded that there should be a free vote on the Government side as well. [Interruption.] Apparently not.
	I now come to the other measures in the Bill. On infection control—a curious theme appears to be emerging—the chief medical officer told Ministers in October 2004 that they should act, through legislation, to provide additional statutory backing. It was not that the Government did not already have the powers, as the 2003 Act more or less gives Ministers the power to set standards and it is possible to proceed in a similar way with respect to standards in the codes of practice. In 2004, however, the CMO said that we needed additional focus then, but Ministers did nothing about it that year. I cannot blame the Secretary of State for that as she did not hold her present position then, but action could have been taken earlier.
	Many things might have been done earlier. The story of MRSA and infection control over the past few years has been one of continuous failure to take the urgent action that is required. I shall provide just one example. The Secretary of State is fond of making a comparison between food hygiene legislation and the responsibilities that should be met in the NHS. The CMO, in "Winning Ways", published in December 2003, said:
	"The new Inspector of Microbiology and the National Patient Safety Agency will work jointly to ensure that the techniques of 'root cause analysis' and the methodology of Hazard Analysis and Critical Control Point . . . are developed for healthcare associated infection and applied in every local NHS organisation."
	That is a direct transfer of experience from food hygiene legislation into infection control. I have searched for any evidence to demonstrate that the inspector of microbiology at the NPSA has acted on that or that it is being applied in any local NHS organisation, but I simply have not found it.
	When the Secretary of State arrived in office after the election, she discovered that there was a big difference between food hygiene legislation and what went on in the NHS. Anyone could have told her that and anyone could have told her that things could have been done about it. We know that some measures will make a difference: hand hygiene, isolation facilities, clear lines of management accountability, pre-admission screening before operations, post-discharge surveillance after operations, accurate reporting of infection data by clinical departments, optimum bed occupancy—the Secretary of State appeared not to know that the number of beds in the NHS was reducing—24/7 access to high standards of cleaning and expert infection control teams. We know that all those things work, but we also know that, in too many cases, those measures are not being taken.
	The Government say that they will bring in a code of practice, so let us look at the draft code to see whether any of those actions that will make a difference are reflected in it. There is no requirement for one board member to have responsibility for infection control and cleanliness. There is no requirement for the standards of cleaning to be in line with the model cleaning contract. There is no requirement for access to 24/7 cleaning on wards. There is no quantitative measure for the availability of isolation facilities. There is no specific requirement for the number of infection control nurses. There is no specific requirement for pre-admission screening before operations. There is no reference at all to post-discharge surveillance. There is no requirement to reduce excessive bed occupancy rates, although we know that there is a strong correlation between that factor and infection rates. There is no requirement for the comprehensive recording and reporting of infections in the terms recommended by the National Audit Office report of more than five years ago.
	Although it has many other elements that are laudable in themselves, the code is not actually about outcomes or enforcing actions that we know will have effect. It is actually about processes and policies. Time and again, we have seen what the Government approach to infection control amounts to—a tick box to say that the policies are in place or that the appropriate processes are being undertaken, but too little emphasis on the actions that will make a difference. Patients have a right to know that action that has been demonstrated to work is being actively pursued within the NHS.
	We need to know—I note that the Secretary of State refused to answer a question on this matter—that targets and financial pressures will not lead to the compromising of patient safety. We must be sure that the NHS is putting infection control at the forefront of its priorities because all the evidence now shows that that is at the forefront of the public's priorities. If it is to deliver, the draft code must be made stronger. The Government's draft code will not survive. At the moment, the Government propose not to supply us with the final code of practice, which would facilitate debate as the Bill passes through Parliament, but to delay it until after the Bill has been passed. That, frankly, is unacceptable to the House.

Kevin Barron: I will leave clause 18 to my hon. Friend the Minister, who may talk about that issue. I am more concerned about the fact that health trusts other than strategic health authorities will have someone specifically responsible for such drugs. That is the most important thing, no matter who in the system does it.
	I am concerned about the fact that the hon. Member for South Cambridgeshire (Mr. Lansley) talked about the weakness of the codes that are likely to come into being to protect us from health-care acquired infections. I may be wrong, but I thought that he said that the draft code was not good enough, but that he had not seen it. That seems a bit of a jump that should be addressed. I understand that the Bill will give the Secretary of State the power to provide a statutory code of practice and to place a duty on NHS bodies to comply with that code, as well as the power for the Healthcare Commission to issue improvement notices to non-compliant bodies. I spoke to Healthcare Commission representatives at a meeting yesterday and they want the Bill to ensure that that can happen. They also want the existing intervention powers of the Secretary of State and Monitor—the Independent Regulator of NHS Foundation Trusts—to be used to take enforcement action.

Andrew Lansley: For the purposes of accuracy, I did not say that I had not seen the code of practice on health-care associated infections, but simply that the Government consulted in July on a draft that struck me as deficient and that they are not proposing to show us a new code, following the consultation, until after the Bill has completed its passage.

Kevin Barron: I misheard the hon. Gentleman.
	I want to move on to the aspect of the Bill that is more contentious. I am very conscious of the fact that I am the Chairman of the Select Committee on Health, which is investigating smoking in public places. The Select Committee has not yet reported to the House, so I want to limit my remarks to the three evidence sessions on 20 October and 17 and 24 November, which are marked on today's Order Paper as being relevant to the debate on Second Reading.
	The Government's intention to exempt drink-only pubs and membership clubs has inevitably caused frustration and anger, not just among the health community but in large sections of the leisure industry that did not want to ban smoking in the first place, but would now prefer a comprehensive ban as that would create a level playing field for them. They do not want to have to consider whether or not they should get out of food and into drink only, given that some sort of ban will be introduced under the Bill.
	During a number of evidence sessions, I talked about my apprenticeship as a young man drinking in South Yorkshire pubs. They were largely full of smoke and men and there was little food beyond a packet of crisps. I hope that that culture has changed in many of those public houses, which I sometimes frequent, and that food and families can be seen in them. They are a lot better than they were in years gone by. I would hate to think that we were going to reverse that change in the culture of drinking in our public houses by introducing a Bill that was not specific.

Steve Webb: The hon. Gentleman's comment gives rise to the interesting point that enforcement will be difficult if what is being smoked effectively has to be inspected. Some environmental health officers argue that if we stick strictly to addressing tobacco products, people could always claim that they were smoking something else, which would mean that an investigation of what was being smoked would be required. A broader definition of smoking could thus make enforcement action easier.
	The exemption for private members' clubs also makes no sense. As the hon. Member for South Cambridgeshire (Mr. Lansley) accepted, that exemption will increase health inequalities. Again, we must ask why the health and welfare of people working in private members' clubs is less important than that of other people? What can the Minister say about the danger of "The Rose and Crown" becoming a private members' club, which would allow people to circumvent the ban by becoming members of "The Rose and Crown"? It would not be beyond the wit of a landlord to circumvent the ban by setting up a membership scheme. How can a ban that is full of exemptions that allow it to be circumvented so easily be worth the paper that it is printed on?

Stephen Williams: I draw my hon. Friend's attention to the initiative undertaken recently by smoke-free Bristol. The city is next to south Gloucestershire. It found that only 12 per cent. of people in the Henleaze ward in my constituency smoke. However, just a quarter of a mile away in the Southmead ward in the constituency of the hon. Member for Bristol, North-West (Dr. Naysmith), smoking is at nearly 50 per cent. Those health inequalities, in a relatively small area, will be perpetuated and expanded if the Bill goes through.

Steve Webb: My hon. Friend is right. For the Government to say that tackling health inequalities is a key priority and then to put in place a measure that will make them worse does not stack up. When they launched the embarrassing statistics in the summer that showed that health inequalities had risen under them, the answer was, "We have these things called spearhead primary care trusts, which deal particularly with deprived areas." When the spearhead PCTs responded to the consultation, they said:
	"Many spearhead PCTs suggest that the proposed legislation will make it harder for them to meet their targets on health inequalities".
	In reflecting on the comment on conflicting targets, we have one bit of the Government setting targets for relatively deprived areas to reduce inequality while another bit of the same Department is making it harder for them to reduce inequality.
	We have heard, and the Health Select Committee was advised in its oral evidence, that enforcement is more difficult with a partial ban. Presumably, I will have to go up to the bar and ask the barmaid whether she sells pre-packaged ambient shelf- stable snacks before I can decide whether to light up. That is the criterion. It is absurd to have separate categories. We heard about Ireland, and if the other customers do the enforcement, they need to be clear about the legislation. If a place serves food at lunchtime but not in the evening, a customer who uses it in the evening is supposed to know that to determine whether he can smoke.

Steve Webb: My hon. Friend makes an interesting point about the liberty argument, which our party considered. We are primarily concerned with the liberty of those who work in such environments, but where addiction is involved, we may, in many cases, being going with the grain. Individuals who want to give up but who have found it difficult might appreciate such a measure. It is not patronising or nannying. It could assist people to do something that they want to do. Perhaps the most appropriate day to introduce the ban is 1 January, although midnight might create operational problems if everyone had to stub out their cigarettes halfway through the evening. Noon on 1 January might be a better time because it would assist those who want to make a new year's resolution to follow the grain of that decision.
	I asked the Secretary of State what she had said to the Cabinet and did not get the straightest of answers. However, we are reliably informed that she pressed for a total ban. If she wants that, then I agree with her. However, it means that her argument that the Labour manifesto only said that there would be a fudgy ban falls down. If she pressed to go beyond that, how did she justify going beyond the terms of the manifesto? She did so because it was right and the best policy to adopt. On smoking, the Westminster Government have got it right, but only for Northern Ireland, where there is a total ban. How, therefore, can they adopt a different approach for England? I can see nothing about the situation in Northern Ireland that would warrant its workers having a different level of protection from those in England.
	The Bill deals with other important subjects. On health-care acquired infections, a group of people who had been bereaved by MRSA held a lobby yesterday. That group—MRSA Action UK—presented a petition to Downing street. I think hon. Members on both sides of the House joined them. I laid a wreath with them at Westminster abbey in commemoration of their friends, relatives and loved ones who had died.
	One thing that the group is calling for is mandatory national reporting of all health-care acquired infections, which we do not have. The estimate is that only 6 per cent. of all infections have to be reported. That relates to bloodstream MRSA only—not all cases of MRSA have to be reported. I hope that the Minister explains why there is not more mandatory national reporting. The scale of the problem is immense and although we heard reassuring words from the Secretary of State about the progress that is being made, across Europe we have one of the worst rates of Staphylococcus aureus infection. It is about 40 per cent. in the UK—one of the highest in Europe—and the right hon. Lady's reassurances were complacent on that front. Having met relatives of those who have died from MRSA, I urge her to listen carefully to what they say and take much more serious steps.
	I echo the question of the Public Accounts Committee—how can the 80 per cent. or so of infections not covered by the Department's mandatory surveillance programme be measured and managed? If they have not even been reported, how does the Department of Health know what is going on?
	We have already heard about things that can be done to tackle infection and about infection control. As for bed occupancy rates, my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) pressed the Secretary of State on what trusts will do if they have two conflicting targets. The answer was "Meet both". I accept that that is the ideal solution, but what if one target conflicts with the other? As the hon. Member for South Cambridgeshire rightly said, what if there is pressure to close a ward because of infection, but that decision is overruled by the trust managers? There is nothing in the Bill to prevent such conflicts, so the Government must make it clear that infection control is a priority.
	The right hon. Member for Rother Valley, the Chair of the Health Select Committee, spoke about the Shipman inquiry, and said that the Bill will improve current practices, which we welcome.
	The Bill includes some worrying provisions on ophthalmology. All I can say is that if dentistry is the precedent, heaven help us. If access to ophthalmology services is cash-limited and restricted, as Opposition Members have said, many of our constituents will be concerned. The Bill was originally to be called the Health Improvement and Protection Bill. The Government dropped the words "Health Improvement" and "Protection", because this is a missed opportunity to do far more of both.

Frank Dobson: No, I would like to make progress, as other hon. Members would like to make a contribution.
	The Government want only a partial ban in England. Smoking is to be banned where food is sold, but it will not be banned where food is not sold. Pubs, clubs and bars serving booze but not food are mainly located in poor neighbourhoods, and serve working-class people, so the partial ban will be good for the health of middle-class people but bad for the health of working-class people, who are ill more often and die sooner than the middle classes. The partial ban introduced by the Labour Government will widen the health gap between the social groups. No one has mentioned the fact that the partial ban will concentrate smokers and smoke in pubs where smoking is permitted, because smokers will move to them from places where smoking is banned. The partial ban will therefore make the situation worse for people in those pubs. It is hard to believe that a Labour Government are knowingly widening the health gap.
	Smoking is one of the major causes of the health gap. Headlines in two Sunday papers said "Glasgow is Britain's smoking capital" and "Glasgow people have the shortest lifespan". There is a clear connection between smoking and early mortality, as has been pointed out by the chief medical officer in his advice to the Government and in his public statements. Professor Sir Liam Donaldson believes that there should be an outright ban, but the Government have decided to ignore his professional advice. It is his job to try to promote good health, but the Government have ignored his advice, just as they have ignored the advice of the distinguished doctor, Professor Dame Carol Black, president of the Royal College of Physicians, who also gave evidence on the matter.
	The Government proposals are half-baked and half-hearted, without any merit at all. Most members of the catering trade take the same view, and they would rather have no ban or a full ban, because half a ban is a great deal of trouble for them. The environmental health officers responsible for enforcing the measure believe that a half ban is unworkable and difficult to enforce. Under the measure, smoking in bar "areas" will be prohibited. What is the bar area? I represent an enormous number of lawyers, and I am sure that they have spotted that wording in the Bill. Some establishments that do not serve food consist only of a bar. Hon. Members may not visit such places, but they exist, so I think that the lawyers will do well. If anyone thinks that they can make a distinction between one part of a room that does not have any smoke and another part that does, they should have tried flying Iberia when the airline banned smoking on one side of the aisle, but permitted it on the other. That ban did not work very well.
	May I tell my hon. Friend the Minister, who has the task of defending the Government's policy, that Professor Alex Markham, the chief executive of Cancer Research UK said yesterday that the Government had a huge number of achievements in tackling cancer to their credit? They have quite a few achievements in promoting the reduction of smoking and helping people to stop smoking, thus reducing the incidence of cancer and improving recovery rates. We should not be distracted and throw that credit away by coming up with this half-cocked measure.
	We have had many debates in the House in the past few years about weapons of mass destruction. The worldwide weapon of mass destruction is the cigarette, which has killed more people than all the weapons, bombs, mines and bullets since the second world war, far exceeding anything that we have managed to do by trying to blow one another up or to shoot one another. In our country alone, it kills more than 100,000 people every year, but we are giving up an opportunity to make progress.
	Finally, last year, I had the singular pleasure of speaking on the same platform in Edinburgh as Sir Richard Doll who, in his 90s, made a fine speech about his initial work to identify the link between smoking and cancer. I made the people present, who were from across Europe, stand in honour of a man who had saved millions of lives. We seldom meet people who save millions of lives, but he has left us an enormous legacy—a better legacy than most politicians are likely to leave, I might add. It would not be a bad addition to his legacy to persuade the Government to introduce an outright ban instead of a partial ban that will not do any good. It will not be enforceable. That partial ban should be avoided by a Labour Government who, as the Secretary of State has said, are dedicated to reducing social and health inequalities, because it will serve to do nothing but increase them.

Stephen Dorrell: I agreed with two things that the right hon. Member for Holborn and St. Pancras (Frank Dobson) said. The first is that we all owe a great debt to Sir Richard Doll, and I am sure that the right hon. Gentleman spoke for the whole House in what he said on that subject. Secondly, the Government's policy on the subject of statutory smoking bans is, in the right hon. Gentleman's opinion and in mine, half-baked and unenforceable. The difference between us is that unlike the right hon. Gentleman and the hon. Member for Northavon (Steve Webb), who both draw from that the conclusion that we should proceed to an outright ban, I shall speak against the principle of statutory smoking bans.
	I do so, as the House is aware, as a former Secretary of State for Health. It would have been an unpopular argument for a Secretary of State for Health in office to advance. I also do it from a personal point of view, as a lifelong non-smoker and somebody who has a deep dislike of smoky atmospheres—so much so that when I go into a pub that has a smoky atmosphere, I go out again, because I do not like it. That is my freedom as an individual, and it is that freedom which lies at the base of my remarks.
	As Secretary of State, I of course received advice from the chief medical officer, and successive chief medical officers have argued in favour of statutory action against smoking. I also met many, many clinical staff who were emotionally committed to the principle that it was part of the Government's job to tilt the system more heavily against smokers. However, we should not proceed on the basis of the Government's half-baked proposal, and still less in the direction that the right hon. Member for Holborn and St. Pancras and the hon. Member for Northavon advocate. I shall set out briefly why.
	At root, my reason is that like my hon. Friend the Member for Witney (Mr. Cameron), I have always described myself as a liberal Conservative. By that I mean, among other things, that I think it is part of our job in this place to defend private space against the well-meaning aspirations of a well-meaning state. I have no doubt that the clinicians who argue for statutory smoking bans do so for the very best of motives. I accord to the Secretary of State and to my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), who argued from the Opposition Front Bench for a different form of compromise, the best of intentions, but sometimes we in this place should defend private space, particularly the private space of unfashionable minorities, among whom we should now number smokers.
	Against that background, I shall go through the arguments that are used to justify the proposals for smoking bans. First—this is the weakest argument of all, which, with respect to him, was advanced by an hon. Member from the Liberal Benches—there are those who say, "It will help me give up smoking". It is not a safe guide for public policy to legislate to encourage somebody to do something that they want to do for their own private benefit. Of course, as a private citizen, one to another, I would encourage people to give up smoking. As a result of the work of Sir Richard Doll and his successors, we all acknowledge that smoking causes cancer and therefore premature death. We should not be mealy-mouthed about that, but we should not use the power vested in us as legislators to impose on people a private benefit that they may wish for themselves, but which they apparently cannot deliver for themselves without legislative backing. That is no basis for public policy.

Stephen Dorrell: I do not agree with that argument. There are very few people, if any, who are clinically unable to give up smoking. I entirely accept that it is difficult, but the right hon. Gentleman needs to be careful of that argument. He is in danger of saying that the people of whom he spoke, in low-income and disadvantaged groups, are unable to make on their own behalf decisions which, from the level of tobacco consumption, one can see that better off people have made. That is not true and it is a patronising argument for us even tacitly to endorse.
	The next argument is closely allied to the argument that a ban will help people give up smoking. It is the argument behind public health targets related to tobacco consumption. As Secretary of State for Health, I was always uneasy about public health targets that could be delivered not as a result of Government action, not as a result of collective action, but only as a result of private decisions by private citizens. It is not a proper basis for public policy to introduce a measure that I find objectionable for the reasons that I am describing, in order to deliver some public health objective about reducing tobacco consumption, which can be delivered only by private citizens making a private choice about their own private behaviour. The job of the public health Minister is to use resources in a way that is targeted at health need, but always to understand that private citizens should be free to make their own decisions about the way they lead their lives.
	The third argument that is advanced is that we should introduce a smoking ban in order to create a more pleasant environment for people like me who do not like going into smoky pubs—again, not a good guide for public policy, and not a reason for compulsion, though a very strong reason for individual publicans and restaurateurs to introduce no-smoking policies in their establishments, which attract people like me and presumably do not attract those who want to go in and be able to smoke.
	On the final argument, it was interesting that the hon. Member for Northavon rested his argument in favour of a smoking ban almost exclusively on the safer working environment argument. All around the country, employers and employees have for a generation been agreeing no-smoking policies in their establishments, without the assistance of the Government. I applaud that. In my own business we operate a no-smoking policy because that is the decision that the individuals on the sites have collectively reached. I do not believe that a ban should be imposed from here, because individual employers and employees should be free to decide the matter for themselves.
	In addition to the public health driver that explicitly informs smoking bans, there is also a strong whiff of political correctness—we know the scientific facts and what is good for the people who send us here. Our righteousness is reinforced when we present that argument, because we can quote scientific evidence to support our assertions of what is good for people. We then make the fatal leap—this is where I part company from the prevailing majority—that because we know how people could better lead their lives from a health point of view, we should use our available powers to lead them to do things that they would not choose to do for themselves.
	The Prime Minister is fond of talking about respect, and he is dead right when he says that we should learn better to respect each other. We should understand, for example, that two adult citizens in a free society—this is almost the definition of a free society—can look at the same set of facts, come to two diametrically opposite conclusions and both be right. We will have learned the real meaning of respect when we respect the conclusions that other people reach when they are presented with the same facts as us, but reach opposite conclusions.

Joan Walley: I have the greatest respect for medical officers, and when the right hon. Member for Charnwood (Mr. Dorrell) was responsible for the health service, a substantial body of medical opinion called for bans such as those in the Bill. I congratulate the Government on going so far with what will hopefully be a landmark Bill on smoking. After 18 years of Tory Government, we should now make as much progress as possible.
	The Bill could have gone much further than a partial ban on smoking. As I said in an intervention, my greatest concern is what the Bill will do for health inequalities. That concern is shared by not only Sir Liam Donaldson in his evidence to the Health Committee, but many other distinguished people. The Under-Secretary of State for Health, my hon. Friend the Member for Don Valley (Caroline Flint), who has responsibility for public health, must satisfy herself that the Government are dealing with health inequalities.
	My primary care trust, which is a spearhead trust, is getting extra money to deal with health inequalities—the increase is some 9.4 per cent. this year and 8.4 per cent. next year. We do not want legislation that makes the matter worse, and the more that I look at the evidence and the situation on the ground—I speak as an ex-smoker—the more I believe that the Government should use the time between now and Royal Assent to make sure that they are doing everything that they can to reduce health inequalities. The issue concerns changing behaviour, because nothing can be done by legislation alone. It involves hearts and minds as well as legislation, and properly trained enforcement officers will be important, too.
	I was interested in the contribution by my right hon. Friend the Member for Rother Valley (Mr. Barron), who is Chairman of the Health Committee. On 24 November, the Committee took evidence from the Chartered Institute of Environmental Health, of which I am vice-president. In its comments, the CIEH makes it clear that it strongly opposes the proposed exemptions for pubs and clubs that do not serve food. The CIEH position is that all workers should be afforded an equal level of protection.
	I have this to say to hon. Members who have already spoken: we are not discussing private places; we are discussing public places. There is no justification for exempting premises where workers are exposed to the greatest risk. The CIEH believes that its members will face the serious ethical issue whether it is professionally acceptable to participate in the enforcement of a law that unjustifiably fails to protect whole categories of vulnerable people and may be open to subsequent challenges under human rights legislation. I urge my hon. Friend the Minister to speak to those who will enforce the legislation.
	I know that time is limited and that many other hon. Members want to speak. In the short time remaining, I shall refer to the issues that concern my local spearhead PCT. Smoking is the single most important cause of illness and death in Stoke-on-Trent, where it kills more than 450 people each year. Are we sure that it is right to leave the most vulnerable workers at risk from the dangers posed by breathing other people's tobacco smoke?
	Exposure to second-hand tobacco smoke has been linked to lung cancer and heart disease since the 1980s, when many people started to campaign to bring about a ban on smoking. In my constituency, 64 per cent. of licensed premises do not serve food and will therefore be exempt from the smoke-free legislation. In the most deprived wards, however, 84 per cent. of pubs will be exempt, leaving both workers and the community at risk and contributing to the social acceptability and normalisation of smoking within those communities. Moreover, the PCT in Stoke-on-Trent and I believe that two out of every three smokers who want to quit are hindered by the environments in which they socialise.
	Hon. Members have already covered many aspects of the debate. I shall briefly refer to the views of Charles Pantin, a consultant physician at the University hospital of north Staffordshire. He has written to me setting out the medical evidence on the risks to health from second-hand smoking, including the links to heart disease, asthma, reduced lung function, chest discomfort and all the other illnesses associated with second-hand smoke.
	This is a momentous opportunity for the Government to make a positive impact on smoke-free workplaces. We must make sure that we are doing everything that we can to help those who want to quit to do so and to prevent people from starting to smoke. This two-tier legislation does not send a simple, concise message. The Bill should contain a comprehensive, simple law to end smoking in the workplace. I urge the Minister to examine carefully the concerns raised by those hon. Members who want to see more being done to reduce health inequalities.

Eric Forth: My two least favourite words in the political lexicon are "modernisation" and "prohibition". When I looked through the Bill, I found that although the first of those is, happily, not present, the second one, sadly, is—right up front. I also found that "regulations" occurs 18 times, "offence" occurs 20 times, and "enforcement" occurs 10 times. In schedule 1, "penalty" occurs 19 times, "offence" six times and "enforcement" three times. What have we come to, that we are being asked to take this approach in order to do what many people see as the right way forward?
	I very much agree with the approach taken by my right hon. Friend the Member for Charnwood (Mr. Dorrell), who succinctly set out the case that is in danger of going by default in this debate: that in a mature, informed society, we should surely leave individuals as much opportunity as possible to exercise their choice and discretion. That should be informed, of course. There is a duty on the Government of the day, and on us, to do what we can to inform people about the risks that they may be taking in terms of their health and safety.

Eric Forth: The policy on drugs has been such an overwhelming failure until now that it is time that we had the courage to look at the issue properly, instead of being afraid of it and cringing from it. That is for another day, however. I shall happily engage in a debate on that subject with the hon. Gentleman, but not here.
	I would certainly want to push as far as I could the freedom of adult, informed individuals to decide what they do with their bodies, and indeed with and between each other. That is my preference. I always recoil when I have presented to me proposed legislation that seeks to impose on a large number of people the wishes of experts or politicians, because that is not why I came into politics or why I am here.
	Another irony is that all of us, in all political parties, pay lip service to local community decision making. I agree with that. However, when we are faced with it as a reality, we tend to recoil from it and resort to centralised decision making and imposition. My solution is that we should encourage workplace decision making of the kind that my right hon. Friend the Member for Charnwood mentioned. I see no reason why proprietors and work forces in offices, factories, restaurants and pubs should not be able to get together to make their own decisions about whether their premises should allow smoking, ban smoking or allow different things in different parts of the premises.
	Last night, I went to St. Stephen's Tavern, right next door to us here in Westminster, to assess the effectiveness of the removal of smoke from the atmosphere. I even lit up a cigarette and puffed at it energetically to see what would happen. Everyone present in the room agreed that although people were smoking, there was no trace of cigarette smoke at all. I can see one or two hon. Friends who were also there. Instead of instinctively saying, as so many politicians do, "We're going to try to use the force of the law to make you good people out there do what we think is right for you", why cannot we challenge people to take a sensible approach to the vexed subject of smoking? Why cannot we challenge proprietors to ensure that their premises are smoke-free by using the technology that is now freely available and was demonstrated to some of us last night? Why not allow that element of choice to prevail?
	As my right hon. Friend the Member for Charnwood said, we can use our power as consumers to try to persuade people to do what we think is right. In other words, if we find smoke offensive, we can decide not to use bars, pubs, restaurants or other premises where it is present. If sufficient of us were prepared to do that, their proprietors would have to make a decision on whether to deem them smoke-free or partly smoke-free.I see no reason why we, as consumers, as well as proprietors and members of the work force, cannot make rational choices in the workplace and in the community. That is preferable to having us here reaching for the law—as we so often instinctively, and wrongly, do—and seeking to impose our view on our citizenry and voters.
	I shall reluctantly support the Bill on Second Reading in the hope that we can water it down in Committee or on Report to move it towards a more truly liberal approach than the rather heavy-handed approach that it takes at the moment. I am not terribly optimistic, but I shall do my best to move it in that direction.

Bob Laxton: Unlike the right hon. Member for Bromley and Chislehurst (Mr. Forth), who could by no stretch of the imagination be described as a zealot about anything, I admit to being a bit of a zealot when it comes to smoking. Indeed, I have been a virulent anti-smoker for many years. If someone put my name into Google or looked me up in "Who's Who?", they would see that I once described smoking as being a dirty, filthy, stinking, antisocial, expensive, bourgeois habit. [Interruption.] That is my weird sense of humour. We all know that these days smoking is generally a working-class habit.
	I approach the subject with an almost missionary fervour. About 10 years ago, when the issue of not smoking was not particularly fashionable, I was leader of Derby city council, where we brought in an anti-smoking policy. We stopped all smoking in the work force and required people who indulged in this dirty, filthy, stinking, antisocial and expensive habit to go to little nicotine-ridden rooms where they could have a quick drag in clouds of smoke. We did that because there was a huge conflict between smokers and non-smokers in open office areas.
	We introduced that policy in June 1995. In November 1995, we went further and wrote it into people's contract of employment and stated it in all job adverts. Applicants were advised that we had a clear non-smoking policy and that, if they wanted to smoke in the workplace, they need not bother to apply for a job at Derby city council. I came in for some heavy criticism. I was told, "You're denying the city council the chance of employing the very best employees around." I replied, "I think that people who smoke are stupid, and why would Derby city council want to employ stupid people?"

Bob Laxton: Yes, there is an argument for that.
	By now, anyone would have concluded that, as a virulent anti-smoker, I would be very much in favour of a total ban across the piece. I took that view until about six months ago, but I have finessed it a little because of some of the impositions that have been introduced on to the statute book. I do not want to drag up banning hunting with dogs, but we have seen that people are circumventing that legislation and operating illegally, or with dubious legality.
	I have changed my position and, if there is a Division tonight, I shall support the Government. The Bill gets us 90 or 95 per cent.—some would say 99 per cent.—of the way to achieving our aim. In talking to heavy smokers, I have found that some accept that smoking is bad for their health, colleagues and families, including their children, but have no intention of kicking the dirty, filthy, stinking, antisocial and expensive habit. Those people will smoke, come what may.

George Young: It is a pleasure to follow the hon. Member for Derby, North (Mr. Laxton), who runs a serious risk of serving on the Committee because, until he spoke, the score was: Secretary of State 0, Labour rebels 3. I hope that the Committee of Selection reflects the variety of opinion on the Back Benches when it chooses a Committee to consider the detail of the Bill.
	Before I deal with part 1, I should like briefly to mention clause 34 on ophthalmic services. The Macular Disease Society is based in Andover in my constituency and it and the Royal National Institute of the Blind have raised some issues that are best considered in Committee about the services that are optional and those that the primary care trust must provide. However, as smoking at least doubles a person's chance of losing sight in later life, that brings me to part 1 and the wisdom of my party's allowing us a free vote. I take a substantially different view from that of my right hon. Friends the Members for Charnwood (Mr. Dorrell) and for Bromley and Chislehurst (Mr. Forth).
	My right hon. Friend the Member for Charnwood prefaced his remarks with a definition of what an individual was entitled to do in a private space. I agree with him. However, the Bill does not deal with what an individual does in a private space. Clause 2 makes clear the spaces that we discussing.
	We have made great progress in reducing the number of avoidable premature deaths that are caused by smoking. The Bill offers an opportunity to build on those achievements. However, there is a risk of a missed opportunity because of the political compromise on which it is built. That is an unsound foundation for a credible public health policy. If, as the Secretary of State implied at the weekend, it is right to introduce a total ban in three years, it is right to do it now. It would be absurd to have two bites at the cherry and two different regimes. It is worth reminding hon. Members, especially Labour Members, of the Prime Minister's words at the Labour party conference:
	"Every time I've ever introduced a reform in government, I wish in retrospect I had gone further."
	That applies to this measure.
	When I was first elected, the House of Commons sold its own cigarettes, with the green portcullis on the pack. My first modest engagement against the tobacco industry was with the then Catering Committee. I asked it to withdraw the product on the ground that it gave parliamentary validation to an activity that killed thousands of our constituents. I failed, but it agreed to reduce the cigarettes from high to low tar. The product was subsequently rightly removed from the shelves.
	Parliament has not hesitated to use legislation to combat smoking. The ban on television advertisements dates back to the 1960s. More recently, we have introduced legislation to ban advertising except at the point of sale. I welcome that. We have also used voluntary agreements but they have been less satisfactory because the industry has been reluctant voluntarily to concede anything that would do it serious harm.
	The Bill is a legacy from the previous Secretary of State for Health, the right hon. Member for Airdrie and Shotts (John Reid). He was not quite as bad as the chain-smoking health Minister in "Yes, Minister", but he did the Department's reputation no good in proposing the compromise a year ago. I recall telling him in the House at the time that it would not work. However, due to secondary lobbying, his influence is pervasive and visible in the Bill. From next March, his constituents will enjoy enclosed public spaces that are free from tobacco smoke, and the risk of lung cancer will fall by 24 per cent. for those helped by that measure in Scotland. However, he has used his influence in Cabinet to ensure that my constituents in Hampshire will not share that advantage. It is not so much the West Lothian question as the West Virginian question.
	It is hard to find a subject on which the Cabinet agrees nowadays. The disagreement on smoking was the best advertised since that on prescription charges 50 years ago. At business questions a few weeks ago, I asked the Leader of the House for a free vote on the matter for Labour Members but the request was dismissed.
	Conservative Members have a free vote. I understand the libertarian argument that my right hon. Friends the Members for Charnwood and for Bromley and Chislehurst presented but a person's freedom to smoke ends where my nose begins. I remind my right hon. and hon. Friends that it became compulsory for motor cyclists to wear crash helmets and car passengers to wear seat belts under a Conservative Government. When I was a health Minister some 25 years ago, I remember advocating the application of fluoride to water supplies in the interests of dental health. Despite the comments of my right hon. Friend the Member for Charnwood, his Government did exactly the things in the interests of public health that he claims that they should not have done. Our party has, in some circumstances and in the broader public interest, curtailed the liberty of the individual to harm himself and others. It is an extraordinary Bill. Indeed, one wonders whether it is a Bill or a Green Paper. Clause 3(2) refers to
	"Examples of descriptions of premises which may be specified".
	I have never come across a Bill with language of that type, being wholly unspecific as to what it is that will be exempt.
	Members have asked whether there are already smoke-free pubs. There are some—12 in Hampshire are already smoke-free. Presumably, that is because it makes financial sense. I say that to reassure those in the trade who are worried that the consequences of going smoke-free will be injurious to their profits.
	It is worth reminding the House that, in 2001, the Prime Minister promised in the Labour party manifesto that we would have a more democratic second Chamber. He then voted for a wholly appointed second Chamber. I hope that the Government Whips extend to all Labour Members the latitude enjoyed by the Prime Minister on the occasion when they get to vote for a total ban.
	I recall negotiating with what was then the Tobacco Advisory Committee in the 1970s, trying to get the health warning not only on the pack of cigarettes but on individual cigarettes. I was told that that was not possible as the ink has carcinogenic properties. My negotiations with the committee taught me one thing, which was that the industry can live with tax increases, health warnings and a larger budget for those with responsibility for health education. It really feared that smoking would be branded as an antisocial unhygienic and unacceptable activity. A ban on smoking in public places would do just that. The industry would do all that it could to qualify that statement, hence its reliance on the ventilation argument and its enthusiasm to have as many exemptions as possible. It will do anything to give legitimacy to the activity by permitting it.
	The industry wants confusion among the public as to where it is and is not legal to smoke. It wants different regimes in different parts of the United Kingdom. That is because the argument would be blunted and the waters would be muddied. The industry most fears a clear statement from Parliament that smoking is an unacceptable activity in an enclosed public space. It is that statement—not an impracticable, illogical compromise—that I hope the Bill will embody when it leaves the House.

Louise Ellman: I praise the Government for the positive and strong efforts that they have made in addressing the problems of smoking. I shall make a simple plea, and that is to say to the Government that they should grasp the nettle, go further than the proposals set out in the Bill and follow the lead from Smoke-Free Liverpool, which proposes a comprehensive ban on smoking in enclosed workplaces, including all licensed premises.
	Smoke-Free Liverpool brings together the city council on a cross-party basis, the primary care trusts, John Moores university, the Roy Castle foundation, the chambers of commerce and the trades council. It has brought those organisations together to introduce a private Bill, currently in the other place, that proposes a comprehensive ban on smoking in enclosed workplaces in Liverpool. The Bill has had its Second Reading in the other place and awaits detailed scrutiny. It is important. It is an initiative that comes from Liverpool. It shows realistically what can be done.
	The impact of Smoke-Free Liverpool has been profound, even in the short time in which it has been in existence. It has been working closely in the community and there has been a 25 per cent. increase in the number of people who want to stop smoking approaching smoking cessation services. There has been work across the communities and work with young people. There has been significant correspondence and discussion with the chief medical officer. Indeed, Sir Liam Donaldson wrote to Smoke-Free Liverpool on 7 November and stated:
	"Finally, I have made it clear that I am totally opposed to the various hybrid proposals that were discussed and my view was made known to members of the relevant Cabinet Sub-Committee."
	He supports the major thrust of the proposals coming from Smoke-Free Liverpool. In his letter, Sir Liam drew attention to the significant change in public opinion on this issue over the past two or three years. It is clear that public opinion is changing. Following the Government's own consultation, it was found that 90 per cent. and more of the 57,000 respondents opposed the exemption for pubs not serving food. Did that include the 11,700 postcards and 8,500 e-mails which were sent as a consequence of that consultation from Smoke-Free Liverpool? There appears to be no reference in those replies in the official report on the consultation. It is significant that that should have happened.
	There have been references to the situation in other parts of the world, including the United States. Scotland has decided to impose a complete ban from next March. Wales has decided to do so when it receives the necessary powers, and they will not be long in coming. The Republic of Ireland has already taken its decision. Northern Ireland Ministers have already proposed similar action there. The Under-Secretary of State wrote to Smoke-Free Liverpool on 26 October and stated that the main reason for him making the proposal was that
	"a key factor in my decision was the evidence that partial controls would create a two-tier workforce whereby some employees would be protected from second-hand smoke while others would not."
	An obvious question has to be asked. If it is right for employees in Northern Ireland—it is not at present under a devolved assembly—to be protected from second-hand smoke, why should that same protection be denied to employees in England? That does not make sense. The statement made by the Minister was clear and unequivocal.
	The issue is about smoking in general. It is also about health and equality, given that that is a major thrust of Government policy. It is particularly about the impact of second-hand smoke and the effect of that on those who are not smokers themselves. Employees must be a prime category in that consideration.
	One reason why Smoke-Free Liverpool emerged was that Liverpool has had, regrettably, the title of the lung cancer centre of the United Kingdom. Indeed, the Roy Castle foundation had its headquarters in Liverpool for that very reason. That is a sad fact, given the prevalence of smoking in Liverpool. We see that 34 per cent. of the population are smokers. If we look more closely at the work done by Smoke-Free Liverpool, that figure increases to 50 per cent. in some of the most deprived areas in the city.
	There is the Government's evidence and the reasons for their current recommendations. They state that throughout the country, presumably, between 10 and 30 per cent. of pubs will be exempt from the ban. That is because they do not serve food. In Liverpool, that figure is 59 per cent. In Liverpool, an area suffering great ill health, six out of 10 pubs do not serve food and a third of pubs currently serving food say that they would stop doing so if the proposals in the Bill came into force. The impact of that would be to increase health inequality.
	The report to the Department of Health from the Scientific Committee on Tobacco and Health underlines the significance of second-hand smoke. The increased risk of heart disease goes up by 25 per cent. The increased risk of lung cancer goes up by 24 per cent. Even low levels of second-hand smoking increases the risk of adults developing asthma by up to five-fold. That is clear, and it should not be accepted. All those risks will be exacerbated for bar workers, who will be subject to second-hand smoking in a concentrated form. That concern should be foremost in our deliberations.

Jacqui Lait: All my life, I have been chary of having good done unto me, and I am afraid that I put the part of the Bill that relates to smoking into that category. That part of the Bill is all that we appear to be talking about tonight. I have always been uneasy about a nanny state. I loathe smoking—I have never smoked—yet I am having to come to terms with an attempt to stop people doing something that they have every right to do. The hon. Member for Derby, North (Mr. Laxton) made a much better speech in favour of the partial ban than the Secretary of State, who did not do at all well in persuading anyone of its merits. Indeed, apart from the hon. Gentleman's rather good speech in support of her argument, most of the contributions from Labour Members will, ironically, probably give her a headache. Unfortunately, she is no longer here to listen to the sad tales that are being told.
	I do not want to talk about smoking; I want to move on to a subject that has not been explored in great enough detail. An optician in my constituency has explained to me the problems that that profession fears will result from the Bill. The Bill, rather than being a public health Bill, seems to be a rag-bag of ideas that the Department has been trying to get off its chest for many years. This is probably the first legislative slot that it has had in which to achieve that.
	On the August bank holiday, the Government announced a review of the general ophthalmic service. Usually, when a Government sneak out such an announcement, it comes under the category of burying bad news. I understand from members of the profession that subsequently there has been absolutely no information on how the review is to be conducted, who is to conduct and chair it, who is to be invited to give evidence, what the time scale will be, whether it is to be an independent review, and when the outcome can be expected.
	At the same time, the Bill is trying to change the terms of practice for a profession that is probably unique in the health service in that it has no waiting lists at all. Anyone who wants an eye appointment with a fully qualified eye specialist can get one at their convenience. If anyone can think of any other part of the national health service where that holds true, I would be interested to know what it is, because I cannot think of one.

Howard Stoate: To answer the hon. Lady's question, another part of the health service in which a person can get an appointment there and then is with a community pharmacist. Such pharmacists are front-line providers of extremely high quality services, and the new pharmacy contract has enabled them to extend their range of services far wider than ever before. I know of no one who had to wait to see their community pharmacist—and they are often open for extended hours and at weekends.

Jacqui Lait: I also seem to remember that it can often take two days to get a prescription filled.
	We can make an appointment with an optometrist to get a full eye test using the most modern technology, and such tests are provided free for certain categories of people. The review of the general ophthalmic service is talking about ensuring that the service remains non-cash-limited, and that any properly qualified practitioner can continue to practise. Meanwhile, the Bill is proposing that the primary care trusts should take over the management of the general ophthalmic service. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) made the point very clearly that because the PCTs are cash-strapped, it is likely that budgets that are now non-cash-limited will become cash-limited and that the PCTs will restrict the number of practitioners and transfer the money to other parts of the service that they provide.
	It would be useful if the Minister could put on record the details, timing and process of the review, so that those who are interested can give evidence. Will she guarantee that the GOS will continue not to be cash-limited, and that the PCTs will not in any circumstances restrict access to the wide variety of optical services that are currently available? If she can do that, this part of the Bill will be acceptable. If she cannot, I fear that many people in the profession will find it exceedingly difficult to live with the proposals in the Bill.

Joan Ruddock: I welcome the Bill. My constituency suffers from grave multi-deprivation, and in the most deprived wards life expectancy is five to six years lower than the national average—so anything that we can do to bring about health improvements is extremely welcome.
	I particularly welcome part 2 of the Bill, because Lewisham hospital in my constituency has had a serious problem with MRSA. The Conservative party, in its election campaign, asked sarcastically:
	"I mean, how difficult is it to keep a hospital clean?"
	In my experience, it is extremely difficult. A hospital can have floors so clean that one can eat off them and still have MRSA. There is a huge need to introduce a new raft of measures, many of which are being pioneered at Lewisham hospital as part of a campaign waged by the Deptford Action Group for the Elderly led by Harry Heyward, me and others to get MRSA rates down. I am delighted to say that rates are now going down. We need to take account of the fact that one in 10 people are found to be already infected in hospital pre-entry testing, and of those who are infected, 40 per cent. come from nursing homes.
	The wide range of measures that the hospital has introduced require a constant battle—a battle to keep infection control regimes in place, maintain the vigilance of health care staff and get the co-operation of visitors. I therefore very much support the proposal for a statutory code of practice and its associated protocols. I am also pleased to note that while the Bill does not cover care homes, the Government have expressed their intention to apply similar measures to cover such bodies.
	My welcome for part 1 of the Bill, however, is not as enthusiastic. When I was growing up in south Wales, I did not know anyone who did not smoke. I started smoking at the age of 14. Fortunately, I did not get addicted, and when I learned the health messages I gave up, as did the rest of my family, with the exception of my father. He was a man who worked in a factory but came home every day to his garden. He got plenty of exercise, was never overweight and had the most healthy diet, having grown his own fruit and vegetables. He died when he was just a few years older than I am today, of an entirely preventable smoking-related disease.
	Today, thousands of my constituents face the same chronic illnesses and eventual premature death as a result of their smoking habit. Twenty-seven per cent. of the people of Lewisham smoke—thankfully, it is no longer the majority that it was in the borough as a whole. As we have heard from others, the incidence is higher in the most deprived communities. Alarmingly, the highest incidence of smoking in my population is among those between the ages of 16 and 34. Interestingly, twice as many white people as black people smoke, and substantially more women smoke. As is the case everywhere, more manual workers smoke. My primary care trust has made huge efforts on smoking cessation and will continue to do so. It can deal with but a few thousand people each year, however, and the problem is so much greater than that. That is why it supports a complete ban on smoking in workplaces.
	The toll of deaths from entirely preventable smoking-related disease is a scandal. In London as a whole, there are more than 10,000 such deaths each year—that is one death every hour in this city, and 120 hospital admissions every day, at a cost of £105 million to the NHS per annum. As others have said, we have known of the hazards of smoking for a very long time. It is gratifying that the majority of smokers now want to give up because of those messages.
	Our willingness to protect others from the effects of second-hand smoking, has been much slower to gain public approval. When I entered the House in 1987, at the first meeting with the Whips—who were less kind, of course, than the Whips today—I asked whether it would be possible to have a non-smoking office. They looked at me askance and said that they I would be jolly lucky—they did not use those words exactly—to get an office at all. A decade later, one of my colleagues, Anne Campbell, who was suffering from asthma, was heard to protest one day that we should not have smoking in our dining rooms. She attracted a huge amount of hostility. Many of us have had to fight hard to introduce the sensible and basic no smoking measures that we have in this place today. How much more difficult will it be in those areas where establishments are supposed to be non-food bars, bars that serve a bit of food, bars without smoke around the bar, or bars with a bit of smoke at the back of the room? It will be extremely difficult, and the Bill as drafted is unworkable.
	One of the most telling statistics that many of us have received came in a briefing from the Trades Union Congress, which compared the 235 deaths at work from accidents with the estimated 700 deaths of non-smokers from second-hand smoking. In the case of accidents, the first thing that we ask is, "Could this accident have been prevented?" Well, smoking can be prevented. The second question that we usually ask is, "Was the employer negligent?" It is my view that, in future, any employer who exposes his or her workers to second-hand smoking will indeed be negligent.
	My right hon. Friend the Secretary of State stressed the limited nature of the exemptions in the Bill. She also stated her passion for legislating for public health. Therein lies a contradiction. We cannot legislate to protect the majority of people and choose not to protect a minority, however small. We will also ill serve those customers who might wish to be protected in continuing to go to the non-food pub that is their local and that they would like to use in the same way as everyone else. As local consultations and other hon. Members have indicated, it is also clear that a proportion of those pubs that currently serve minimal food will cease to do so in future and become smoking pubs. We want them to keep offering food, not to give it up, because giving it up will exacerbate the difficulties that we have with our drinking culture.
	For all those reasons, I and many Members will seek every opportunity to remove exemptions for licensed premises and private clubs from the Bill, and to establish a total ban that will protect all employees and the public at large and further encourage the many people of this country who are seeking to give up smoking.

Paul Burstow: On the basis of the research that the Select Committee has seen so far on the efficacy of ventilation systems, in terms of both cost-effectiveness and practicalities, I am not convinced that that can be achieved—not least because the level of air change required for the achievement of the necessary safety standards would be high enough to make patrons uncomfortable. It is likely to be really effective only when the bar is empty, which rather defeats the purpose.
	A disproportionate amount of time and money will be invested in defining, and then enforcing, the exemptions. The more complex the regulatory system, the greater will be the burden on business and the cost to consumer and taxpayer. As we have heard, the Health Committee has received evidence from the hospitality trade, the Health and Safety Executive and local authority enforcement officers. They all agree that a partial ban will be more expensive to enforce.
	During the Committee's visit to Dublin earlier this month, it was clear that the ban in the Republic was working well. One reason is that it is easily understood and, as a result, largely self-enforcing. Compliance is currently 94 per cent. Enforcement action has been necessary, but in only a small number of cases. The Secretary of State cited experience in Norway as evidence that comprehensive bans do not come along in one go, but must come along in stages. In Norway, however, the partial ban was abandoned in favour of a comprehensive ban because it was proving unfair, unpopular and unenforceable. As my hon. Friend the Member for Northavon (Steve Webb) said, why should we make the same mistakes in this country and then implement a full ban later?
	The fact of devolution should not mean that Ministers in Westminster ignore the lessons from Edinburgh and Cardiff—and, indeed, from non-devolved Belfast. Why should Health Ministers in Scotland, Wales and Northern Ireland be wrong and Health Ministers in England be right? It has been suggested that Ministers here feel that England is not yet ready for a comprehensive ban. Even if we accept that argument, however, surely it is the Government's duty to act on the basis of scientific evidence.
	Let me respond briefly to points made by the hon. Member for Lewisham, Deptford and the right hon. Member for Charnwood (Mr. Dorrell). Surely the choice is between comprehensive and comprehensible legislation after we in the House of Commons have debated and framed the law, or allowing the courts to drive bans through by means of individual decisions under health and safety legislation or precautionary steps taken by employers. I do not consider that a satisfactory basis on which to proceed. We should be legislating in a comprehensive fashion.
	During the Select Committee's visit to Dublin, I was struck by how quickly public opinion had moved on in the Republic. There is now a tangible sense of pride at what has been done in Ireland. The Irish Government saw the need and gave a lead, and that is what should happen here. Public opinion in England is moving and it is time for the Government to move as well, not least on the issue of exemption for bars that do not serve food. Of the 41,833 people who responded to the Department's questionnaire, more than 90 per cent. said that there was no basis on which they would accept such an exemption.
	The Secretary of State has achieved an unusual feat. At the same time as dividing the Cabinet, she has managed to unite ASH and the British Beer and Pub Association in opposition to a partial ban. Public opinion in England is already more supportive of a comprehensive ban than was the Republic of Ireland before its introduction there.
	There can be no doubt that a partial ban will widen health inequalities, as a number of Members have pointed out. According to a survey by ASH, following a partial ban two out of five pubs would close their kitchens permanently and adopt non-food status so that they could allow smoking. Last Thursday, when the Health Committee took evidence from the chief medical officer, Sir Liam Donaldson, I asked for his professional opinion on a partial as opposed to a comprehensive ban in terms of health inequalities and outcomes. He said
	"It . . . signals to the public that a drink and a smoke go hand-in-hand when all the efforts on smoking and tobacco control have been aimed at de-normalising smoking".
	He said that it put Britain among the laggards of public health policy internationally rather than among the global leaders. Laggards not leaders: that must surely be the consequence of ignoring the chief medical officer's compelling advice.
	When I intervened on the Secretary of State earlier, I mentioned the regulatory impact assessment. The detailed tables show that the difference between a partial and a comprehensive ban is 200 preventable deaths a year. The idea of exempting pubs that do not serve food is ill-conceived. It is a classic case of doing what is expedient rather than what is right. Health policy should be evidence-based, not evidence-blind. I agree with the chief medical officer that when it comes to the question of freedom, the smoker's right to smoke stops at my nose.

Iris Robinson: I make no apology for the fact that I intend to speak principally about the smoking ban. It would be remiss of me, however, to let pass without comment the views of the hon. Member for Sunderland, North (Bill Etherington), who spoke about those who shout the loudest winning and about the importance of carrying minorities with the majority. I wish that the same could be said when we speak from the Northern Ireland Benches. I wish that our voices were heard—and we are certainly not a minority within the Northern Ireland context.
	I have found the debate on the partial ban on smoking in public places, which the Government are in favour of, most interesting. I am grateful that, after extensive lobbying in Northern Ireland, plans have been announced for a total ban on smoking in public places there. Again, it would be remiss of me not to point out how ironic it is that the Government are willing to protect the health of Northern Ireland citizens by introducing a comprehensive ban on smoking in public places while they are also willing to give an amnesty to on-the-runs who have murdered men, women and children, allowing them the freedom to return home to the Province and move freely among their victims.
	There is no logical reason why staff in one pub or club should be protected from the dangers of passive smoking, while those in another should be exposed to them. As already highlighted by hon. Members, a partial ban allowing smoking in pubs where food is not served fails to protect workers in the hospitality industry, who are often at risk of the greatest exposure. On account of the inequalities contained in the Bill, I suggested to the right hon. Member for Rother Valley (Mr. Barron) that pubs serving food will simply get rid of the food business in order to attract the smokers and maximise the takings on alcohol sales. That will inevitably lead to redundancies in the catering trade. The right hon. Gentleman claimed that it did not seem to be an issue in the Republic of Ireland, but, with respect, I would point out that the population of the republic is approximately 5 million, compared with a population in England of approximately 55 million, so there is no real comparison to be made in terms of job losses.
	Many hospitality workers are low paid and failing to protect them from the effects of smoke at work will only increase health inequalities in that group. Such a policy would be impractical, unfair and lacking in rationale. As I said in an earlier intervention, Macmillan Cancer Relief pointed out that more than 37,000 new cases of lung cancer are diagnosed each year in the UK. Perhaps the Minister will tell us why the Government have chosen to ignore the advice of the chief medical officer, Sir Liam Donaldson, who proposed a total smoking ban, and why the views of 90 per cent. of respondents to the Department of Health's own consultation who supported a full ban without exemptions have also been ignored.
	The BMA has stated that second-hand smoke increases the risk of lung cancer by 20 to 30 per cent., increases the risk of heart disease by 25 to 35 per cent., doubles the risk of stroke and causes asthma, respiratory illness and ear infections in children. Those particularly vulnerable to second-hand smoke include 8 million people with lung disease, 2.1 million people with angina, 1.3 million people who have had a heart attack and 300,000 who have had a stroke. There are also an estimated 10.8 million women of child-bearing age, some 750,000 pregnant women and 1.5 million children with asthma who would all be at risk. Short-term exposure to tobacco smoke also has a measurable effect on the heart in non-smokers. Just 30 minutes' exposure is enough to reduce coronary blood flow.
	Nicotine addiction is the main motivating factor behind smoking. Smoking is the greatest cause of preventable illness and death and giving up smoking at any age confers substantial health benefits. Individuals who wish to stop smoking must be offered appropriate support and smoking cessation services must be widely available. Extra training should be provided to doctors and other health care professionals to enable them to assess and refer individuals to specialist services. Similarly, those services should be offered to workers at places where smoking is now to be outlawed.
	If the Government fail to implement a total ban, England and Wales will trail behind many other parts of the world. The hon. Member for Northavon (Steve Webb) pointed out earlier that seven US states have now banned smoking.

Iris Robinson: I am aware of that and I withdraw the point about Wales.
	I was about to say that New Zealand became a smoke-free zone on 10 December 2004. Dr. Tricia Briscoe, chair of the New Zealand Medical Association, commented that that country's
	"experience shows that introducing smoke-free legislation makes people more aware about the health impacts of second-hand smoke. And the legislation is popular. Polls now show that 9 out of 10 New Zealanders support the right to work in a smoke-free environment."
	Dr. William Glasson, federal president of the Australian Medical Association said:
	"The Australian experience shows that when workplaces are smoke-free, families are more likely to have smoke-free homes. The proportion of family homes with smoking restrictions more than doubled in 8 years. That means that fewer children are at risk from chest and ear infections, asthma and cot death."
	I hope that that supports the argument advanced earlier by the hon. Member for Liverpool, Riverside (Mrs. Ellman).
	Environmental tobacco smoke is also detrimental in terms of the economic effect that it has on businesses due to loss of productivity from sick days and increased insurance due to fire risk. Effects on businesses have often been cited as a reason not to pursue a smoking ban, but evidence from countries that have become smoke-free show positive, not negative, effects on businesses. In New York, receipts in bars and restaurants increased by nearly 9 per cent. in the first year of going smoke-free and reports in the Republic of Ireland suggest that there were no negative effects on sales in bars and restaurants. In fact, many more non-smokers are now going out to restaurants and bars.
	Research found that air quality in pubs in the Irish Republic improved significantly in the first year after the introduction of the smoking ban. According to the findings, the level of carbon monoxide among non-smoking bar workers fell by up to 45 per cent. Among ex-smokers, the levels dropped by 36 per cent. These are compelling figures, as I am sure that all right hon. and hon. Members would agree.
	Studies also show that smoke-free workplaces encourage smokers to quit or reduce consumption—hence addressing a major cause of ill health. The fall in tobacco sales in the Republic of Ireland provides further evidence of that. Dr. James Reilly, president of the Irish Medical Organisation, has stated:
	"Over 7,000 smokers gave up in the 6 months before the law came into force. The new law has encouraged many more smokers to quit—as is evident in the continuing drop in tobacco sales—and they say that they are less likely to start again because their workplaces and social venues are smoke-free."
	The Republic of Ireland introduced legislation in March 2004 to ban smoking in all public places and workplaces. That has proved to be very successful and highly popular, and no major compliance problems have been encountered. Useful lessons could be learned from that approach. The key to success in the Irish Republic was a clear policy, an effective public information campaign outlining the rationale and clear enforcement laws.
	The health and economic evidence is clear and there is widespread support for such a policy. I urge the Government to ensure that any ban is total. That will protect the health of all workers and tackle a major cause of ill health by providing environments that encourage smokers to quit or reduce their consumption. Partial bans rarely work. They please no one in the end. As my dear mother taught me long ago, "If you stand in the middle of the road, you'll get knocked down." The partial ban is morally wrong: it should be a comprehensive ban. Just as extending opening hours for drinking alcohol is morally wrong, all we will succeed in doing is to fill more hospital beds.

David Taylor: In just a sentence, my hon. Friend has demonstrated the lunacy of the case of the tobacco manufacturers.
	Speaking as a Labour MP, I would argue that smoking is all the more important because of its impact on social and health inequality. The chances of a man in social class 1—the richest—living until the age of 70 are, on average, two in three. For a man in social class 5—the poorest—the chance of living that long is less than one in two. Half that difference is down to smoking. More poor people smoke than rich. And more poor people die as a result from lung cancer, emphysema, vascular disease and all the other terrible conditions that smoking causes.
	We must lighten that burden of preventable suffering, not widen the gap. I shall look favourably on Government interventions with that objective. Part 1 of the Health Bill is just such a major intervention. A giant step is being taken to protect the great majority of workers and members of the public from carcinogenic second-hand smoke. However, the proposed exemptions will fail to protect a large group of employees and customers in the hospitality industry. They will introduce further market distortions, lead to unfair competition between licensed premises and generate public order problems. That latter point has not been made so far today.
	No wonder affected groups have been so vociferous about the Bill, including those with pre-existing medical conditions such as asthma. Asthma UK has calculated that one in five people with asthma may still be prevented from using parts of their workplace where people smoke because of cigarette and other tobacco fumes. The best estimate of the number of premature deaths caused by workplace exposure to other people's smoke is 600 a year, although other estimates have been quoted today. Compare that to the 200 or so people who die in this country every year from all other industrial injuries and accidents. Let us stop pretending that smoking is not a workplace health and safety issue.
	Bryan Ferry and other popular singers of recent times were only partly right. Smoke gets in your eyes, but it also gets into your hair and clothes, into your blood stream and onto your death certificate. Many workplaces still permit smoking and they are generally in sectors with the highest levels of exposure and, therefore, the greatest health and safety risk. Most of them are operated by small firms that employ relatively low-paid staff. Workplace smoking is particularly common in the hospitality trades, including restaurants, pubs and casinos, but it is not confined to such places. The latest Government survey shows that more than 2 million people in Great Britain work in workplaces that allow smoking throughout. A further 10 million people work in places where smoking is allowed somewhere on the premises. In total, that is almost half of the work force.
	In Ireland, as we have heard, smoke-free legislation was introduced to tackle a similar starting position. Since its inception in March 2004, it has received wide public support and is well on the way to proving a great success. I was able to visit Dublin in September last year in a delegation drawn from the all-party group on smoking and health, which I chair. There were representatives from both Houses, including that excellent campaigner in the other place, Lord Faulkner. We talked to Irish parliamentarians at the Dail, including Health Minister Micheal Martin, licensed victuallers, cancer consultants, trade unionists, and drinkers and smokers in the Temple Bar area—the Dublin equivalent of Leicester square. The reaction to the then six-month old ban was hugely positive. I hear that the Health Committee visit this autumn had very similar findings. Objective Irish evidence does not bear out the claims of the tobacco lobby here and parts of our hospitality trade that smoking restrictions have been bad for business, which is in fact improving.
	Welcome as the Health Bill is, the exemptions for pubs that do not serve food and for membership clubs make no sense at all. They will increase health inequalities. They will make the law harder and more expensive to enforce, and they will, as I have said, produce unfair competition right across the hospitality industry. On health inequalities, a major survey of more than 1,200 pubs, conducted by survey firm IFF Research Ltd, has shown that those not serving prepared food are concentrated in poorer communities—no great surprise—where smoking rates are already highest. On average, about 14 per cent. of pubs in the richest areas do not serve food, compared with 45 per cent. in the poorest areas.
	Worse still, if the current exemption survives the parliamentary passage of the Bill, publicans say that many will stop serving food. The IFF survey suggests that in future the percentage of pubs not serving food in the richest areas will rise to 20 per cent. and in the poorest areas, the majority will not serve food. That shift would also be disastrous for the Government's alcohol strategy, a key part of which is to cut binge drinking by encouraging consumption of meals when alcohol is drunk.
	After the devastating evidence from, and indeed near resignation of, the chief medical officer last week, I have no doubt that the Health Committee will report in favour of the comprehensive legislation that was indeed the overwhelming choice of the 60,000 respondents to the Government's recent consultation. I suppose that it is possible that the Government might be able to keep the exemptions in the Bill if they are prepared to rely on Tory support to do so, although more and more Tory MPs are recognising the case for comprehensive legislation, too. I know that the Prime Minister will not be unaware of the political fall-out that such a situation could cause.
	Thus an end to all smoking in workplaces and enclosed public places would protect non-smokers from the damaging effects of second-hand smoke, and would encourage many smokers to quit.

David Taylor: I stand second to none in the Chamber in my admiration for the upright stance and integrity of my near-neighbour in Lichfield. I look forward to having a chat with him in the Lobby.
	On health and safety grounds, there should be no exemption for any pub or membership club. It is wholly unacceptable to exempt any category of worker—I say that with great respect for my hon. Friend the Member for Sunderland, North (Bill Etherington)—from an identified, controllable and significant risk. Good gracious me, the bulk of Labour Members were trade unionists in another life.
	Exempted pubs and clubs will be in less well-off areas, where smoking prevalence rates are higher, and general health and life expectancy are worse than elsewhere. We have heard that that is shown at its starkest in Liverpool, with its sad and unique position as the lung cancer capital of England, and with average smoking prevalence in the most deprived areas at around 50 per cent. No wonder the call for change is even stronger on Merseyside than elsewhere. I commend the Smoke Free Liverpool campaign; I wear its wristband proudly as a token of my support—the first such wristband I have ever worn.
	While the partial ban proposed in the Bill will protect many workers and members of the public, it will leave some of those at most risk still exposed to the health risks of second-hand smoke. In summary, it will also reduce the number of smokers quitting as a result of the legislation, worsen health inequalities and produce perverse and unfair competition between licensed premises.
	Smoke-free legislation is essentially a yes/no question, ideally suited to a Chamber with just two Lobbies. Once the health and safety case and the public health benefits are conceded, it is not possible to find a compromise, whether exemptions for some premises, ventilation systems or separate smoking areas are incorporated. All of that is lunacy. It is impossible to find a compromise that is practical, logical and enforceable.
	There is still time for the Government to ensure that workplaces and enclosed public places in England will have the same protection from second-hand smoke as will soon be available in Scotland, Wales and Northern Ireland and which already exists in the very enlightened Irish Republic. The benefits and popularity of such a measure would be enormous.
	My parliamentary neighbour, the Secretary of State for Health, my right hon. Friend the Member for Leicester, West (Ms Hewitt), has said that a comprehensive workplace smoking ban will be in place by 2007. I hope that she is right, and that second thoughts and sound advice will prevent my Government from snatching a wholly unnecessary defeat from the jaws of a much-needed historic victory. For then, 400 years after the first tobacco ban was promulgated by an absolute monarch, an absolute ban in enclosed public and work places will at long last be a reality. If that is not a reason for public rejoicing, celebrations and, yes, bonfires, then I do not know what is.

Richard Taylor: I have to admit that I am one of those described by the hon. Member for Sunderland, North (Bill Etherington) as a zealot in favour of the total ban. I am in good company because I join the right hon. Members for Holborn and St. Pancras (Frank Dobson), for Rother Valley (Mr. Barron) and for North-West Hampshire (Sir George Young), and other right hon. and hon. Members.
	We must face up to the fact that the reason for a ban on smoking in public places is to protect the health of all workers. All workers have equal rights to a healthy environment. That is the answer to Ministers who claim that, because we are protecting 99 per cent. of workers, we are doing all right. The problem is that the 1 per cent. we are not protecting work in the most smoke-filled environments. People do not go to work in a factory or a shop to smoke, but many of them go to the pub to smoke. It is the 1 per cent. who are not protected who are the most worthy of protection.
	The Health Committee had to face the libertarian argument. A reader in biomedical ethics at Imperial college was asked, "How do we defend the fact that we are attacking people's liberty?" He said:
	"It is a simple idea, first set out most clearly by John Stuart Mill in the mid-19th century, the idea that the main way in which you can justify restricting someone's liberty is where they are causing harm to others."
	Much as I object to restricting people's liberty, if it causes demonstrable harm to others, it is justified.
	In relation to the trip to Dublin, I want to add some figures to facts that were mentioned by other hon. Members. Support for the total smoking ban in Dublin before it was introduced was 67 per cent., which included 40 per cent. of smokers. Within a year after its introduction, 93 per cent. said it was a good idea, 80 per cent. of whom were smokers. A total ban can be popular. Compliance is high. It is easily understood and enforceable, and it is now a pleasure to go into pubs in Dublin.
	The arguments against the partial ban have been mentioned at length. They include the worsening health equalities and the fact that it is illogical and unenforceable. The people who impressed me in the Health Committee were representatives of the Bingo Association. We all have a lot of little old ladies in our constituencies whose only outing in the week is to go to the bingo hall. They probably smoke and drink while playing bingo. However, the Bingo Association wants a level playing field. Without a level playing field, bingo would move to other places such as pubs that do not serve food and where smoking is allowed, which would be quite wrong.
	On our visit to Dublin, members of the Health Committee met a chest physician, Professor Luke Clancy, who reminded us of the effect of the Clean Air Act 1956 on London. I was a senior house officer at St. Stephen's hospital when that Act was enforced piecemeal by different local authorities. Professor Clancy reminded us that it took a decade effectively to lower levels of smog and produce health benefits. Ireland has adopted a big bang approach to a ban, which has worked, and it is the only way forward for us.
	I shall take a leaf out of the book of the hon. Member for Southend, West (Mr. Amess) and look at other equally important parts of the Bill. I am glad that the Government are going to issue a code of practice with related sanctions on the prevention and control of health care-associated infections. I welcome the Secretary of State's comments that the code will be based on existing good practice and that waiting list targets will not compete with infection control. However, there are some points that must be included in that code. Yesterday, with the right hon. Member for Rother Valley, who chairs the Health Committee, we met members of MRSA Action UK and MRSA Support, who expressed vitriolic anger about the lack of communication. One of my criticisms of the health service, particularly hospitals, is that communication between staff—nurses and doctors—and patients, is sadly lacking, possibly as a result of overwork. Members of those groups had relatives who had died of MRSA, but they had not been told that that was the cause of death. One of them alleged that they had received an unacceptable death certificate that just said, "Multi-organ failure due to sepsis." In my day, no registrar would accept such a certificate, because one had to say what had caused the sepsis.
	Openness with the patient and the family is therefore needed, and to help with that, it may be necessary to formalise notification of those illnesses and make it mandatory. The list of notifiable diseases is under review, but diseases such as smallpox which, hopefully, has been eradicated, are still included. Hepatitis C and Legionnaire's disease are not on the list, and hospital-acquired infections and bugs, including MRSA and Clostridium difficile, which are serious pests, have never been included. There is an MRSA surveillance scheme, but it is not tough enough, so will the Minister consider introducing formal notification of those illnesses? If that is too cumbersome and slow, can another method be used?
	As for the code of practice, most hospitals, if not all, have infection control teams, many of which follow protocols. During a previous Health Committee inquiry, our attention was drawn to the formulary used by University College hospital in London. Page 280 of the 2002 edition includes protocols for the eradication of staphylococcal infection and refers to protocols for the management of patients and staff with MRSA. I hope that such publications will inform the code of practice. The Healthcare Commission prepared a submission for our debate, which says:
	"It will be vital that the code of practice is fully workable in practice and the Healthcare Commission urges that due time, consideration and consultation be taken over its content."
	Part 3 deals with drugs, medicines and pharmacies. There is no place for lax management of controlled drugs. When I was a house physician a quarter of a mile from here at old Westminster hospital, the control of scheduled drugs was lax. Much has happened since then, and controls must be tightened up. However, pharmacists have considerable worries about the Bill, as the hon. Member for Romsey (Sandra Gidley) will know. I hope that in Committee those worries will be taken on in detail. Pharmacists do not know in detail the supervision requirements. How many pharmacies will one pharmacist be able to supervise? They are worried that the Bill may exacerbate the shortage of pharmacists.
	To conclude, there are good parts and bad parts in the Bill. Returning to the subject of smoking, at the large cancer conference last week, an oncologist from Glasgow, who is very lucky to have the complete ban, said loud and clear that the one most important thing to improve the prevention of cancer was the total ban. Everything else, he said, was lip service.

Andrew MacKinlay: No, I cannot give way; I do not have time.
	We want more effort from the Government. They have begun to deal with the problem, but the message is that Ministers, Labour and Tory, should listen to Back Benchers more, instead of listening to civil servants, and give us at least some credit for possibly knowing what we are talking about. Legislation and administration would be much better, and we could have started to combat MRSA a lot earlier, had people listened.
	On smoking, we are told that the chief medical officer nearly resigned. He should have resigned, in my view. It is not very brave of him to say that he nearly resigned. It is an extremely important issue. In a small way, I quit one course of my career partly because of smoking. When I was first elected to this place, I was persuaded to be a Whip. Let me share with the House the fact that I did not like that at all and found it very uncomfortable. I aspired to more than reading out the folder every night and being a choreographer. In opposition, the Whips were all men, so I qualified on that count, but they were all smokers—it was like pea soup in the Whips room—which was one of things that made me quit. The situation was offensive and I could not alter it. I remember sitting there thinking, "I don't need to put up with this", which is when I went to see Mr. Foster and said, "I don't want to be a Whip." The rest is history.
	The right hon. Member for Loughborough—

Andrew MacKinlay: A large part of England, anyway.
	Earlier, the right hon. Member for Charnwood (Mr. Dorrell) said that employers and employees are working gradually to provide smoke-free workplaces. The truth is that employers are now moving to insist on smoke-free workplaces because they fear litigation. Whether or not we pass the Bill, employers are receiving a growing weight of advice that they could face some serious class actions in the future, because they failed to provide their workers with a smoke-free environment.
	The right hon. Member for Bromley and Chislehurst (Mr. Forth), who is not in his place, has mentioned prison officers. We have a duty of care to prison officers and prisoners, regardless of whether we pass this legislation, and future Governments may face serious litigation by them.
	I support the Bill, although it does not go far enough. I am deeply disappointed that it contains exemptions that will muddy the waters, that will not provide clarity and precision, but will provide the chemistry for division, argument and lack of enforcement. The burden of enforcement will be placed on bar owners and bartenders, whereas the ban in the Irish Republic has been enforced by peer pressure.
	The Minister's notes state, "Keep repeating the mantra, 'It's in the manifesto.'" It will not wash. This is a good Bill, and I shall join the overwhelming majority of hon. Members in supporting it tonight because we want a ban. However, the manifesto did not say, "Thus far and no further." Does the Minister want me to conduct an audit of the policies that have not been implemented, although they were included in the manifestos on which we have stood, and the policies which have been implemented even though they were not in a manifesto? The Bill is in line with the manifesto, but so are my hon. Friends who are calling for a comprehensive and immediate ban along the lines of the policy introduced in the laboratory conditions provided for us by the Irish Republic, where the ban has worked.
	I represent quite a poor, working-class area, which has the highest indices of heart disease, respiratory complaints, diabetes and asthma. I resent it when hon. Members who represent constituencies where a ban will be implemented because of devolution tell me that a different duty of care will apply to my working-class constituents. I should have thought that a Labour Government would not want the West Lothian question to be raised, and I did not raise it—other hon. Members raised it by interfering in the health care of my constituents and of others in England.
	I believe that there is a majority in this House for a comprehensive ban. A week and a half ago, the Government were comprehensively defeated—they persuaded me to join them in the Lobby, which I rather regret now. They are not reading the political tea leaves because there is a majority in this House for a complete ban, but if they want to go down to a further defeat, that is their decision.
	When the Secretary of State discussed the Bill, she said that she was proud to introduce it. She should be proud because, as she said, when the Bill goes through—flawed as it is—hundreds, nay thousands, of people will live longer as a consequence. Why would she allow it to be spoiled or diminished by not introducing a total ban on smoking in public places?
	Libertarians say that people have the right to choose. I believe in full knowledge and full consent. However, in this case, we cannot provide full consent. We will have a ban in pubs, but not in working class clubs. Young children are entitled to go into those clubs, and they do. We need to recognise that fact. The Secretary of State says that the ban will apply not only in the bar area but in other areas. That is nonsense, because it cannot be defined. There is bound to be argument and avoidance based on that fudge.
	I hope that the Government will have the humility and common sense to reconsider the one area that has aggravated many Members on both sides of the House, but particularly among their Labour colleagues, who welcome the Bill and are proud to support it but see it flawed by sheer cussedness. The problem is that—

Charles Walker: Thank you, Madam Deputy Speaker, for calling me to speak in this important debate.
	My father died at 46 from throat cancer. I am an ex-smoker who smoked a lot. We both made our choices. I might therefore be expected to speak in favour of a total ban, but far from it. I have read the briefs from the learned gentlemen and organisations proposing a ban— the chief medical officer, the British Medical Association and the British Heart Foundation. They are all experts and they all want the Government to implement a comprehensive ban on smoking. I congratulate the Government on having the courage to say, "Yes, you are experts, but the role of Parliament is to balance the interests of various groups, non-smokers and smokers." If Dr. Liam Donaldson wanted to have a hissy fit because he is an expert and the Government would not implement his advice, they would have been well advised to accept his resignation.
	What confuses me about this debate is why we get so pious about second-hand smoke even though the science is still a little shaky. We all experience the implications of second-hand alcohol—drunks who turn our town centres into war zones, drink-drivers who maim and kill thousand of people on our streets, and alcoholic parents and children who destroy families. When, Madam Deputy Speaker, was the last time you smoked 20 B& H and went home and beat up your husband or partner? It simply does not happen. If we are interested in protecting innocent parties, why on earth did this House vote to have 24-hour drinking? The implications of alcohol are far more pronounced and far better known than those of smoke.
	Is smoking the ultimate evil afflicting our modern society? I talked to a headmaster at one of my local comprehensive schools who said, "Yes, smoking is a bad thing, but what really worries me is young people coming to school hungover or drunk and unable to participate in the day from beginning to end. A few of my students may be smoking behind the bike sheds two or three times a day. I disapprove of that, but at least they can take part in the school day." We compare cigarettes to drugs and alcohol. Cigarettes are addictive, but they do not rob people of their free will as drugs and alcohol do.
	We have several extremely bold and courageous charities in Hertfordshire that help people to break severe addictions that lead them to violence against others and themselves. Several of them smoke and I am pleased that the Bill provides for people in residential situations to be allowed to continue to smoke. However, the charities also provide day-care services. It would be appalling if the Bill did not allow those who receive treatment for drug and alcohol addictions to smoke and, because they could not smoke to relieve their tension and angst, they went back on to the streets and pursued a life of violence again to feed their habits.
	I have probably spoken for too long—I am full of passion and I would love to go on for longer. I shall make one final point. In Scotland, it appears that £66 million will be provided over the next three years for enforcement. If that were extrapolated to the UK, the figure would be £660 million for smoking-cessation officers. If the British public were presented with a choice between £660 million for smoking-cessation officers and the same sum for 4,500 new police officers, I believe that they would opt for the latter.

David Kidney: I congratulate the hon. Member for Broxbourne (Mr. Walker) on his passionate speech.
	I begin with the killer health care-associated infection in the hospital setting. I am proud of my local acute hospital in Stafford. It was a delight to write to the hospital recently to congratulate the management and staff on hitting the December target for waiting times two months early. No one now waits more than six months for an in-patient operation or more than 13 weeks for an out-patient appointment.
	However, Stafford hospital featured in the general election campaign in a different light because of some misinformation from the Conservative party, which suggested that the rate of MRSA infections at the hospital was the equivalent of that for every infection in the past year in the west midlands region. When challenged, it said that that was a mistake. However, a similar incident occurred in Harrogate at the same time. Again, the Conservatives said that they had accidentally cited a regional rather than a hospital-specific figure. One such mistake may be misfortune, but two reek of gross carelessness if not worse in trying to frighten voters into making a particular choice at the election.
	The infections are serious and Stafford hospital makes a conscientious attempt to test every vulnerable patient who enters the hospital. When I tour the laboratories at Stafford, I never cease to be impressed by the dedicated work of the scientific staff who carry out the tests. I know that my local hospital takes the matter seriously and we welcome the provisions for a new statutory code of practice coupled with a duty on the hospital to fulfil the standards, which the Healthcare Commission will enforce and inspect.
	I should like to focus on the provisions that presage a much greater change in primary care services. We await the White Paper in the next few months, but the Bill contains some evidence of the Government's intention to make primary care services much more responsive to patients' needs. First, let me consider the provisions for pharmacists. I have been impressed by the willingness of pharmacists in my constituency to extend their role in primary care services, whether through help with smoking cessation, prescribing medicines—they are very much up for that—giving confidential contraception advice or helping people with long-term medical conditions to manage their medicines. They are a tremendous benefit to my local health economy. I visit local pharmacists regularly and have seen the changes that they have made in the skill mix of their staff and in their physical premises, which now include private places for confidential consultations. I therefore know that the changes on supervision and charges for which the Bill provides will rightly help to contribute to a greater role for pharmacists in primary care.
	The same goes for my recent visit to the optometrists Webb and Lucas in Bridge street, Stafford. Like other hon. Members, I was lobbied about the changes in the Bill to the general ophthalmic services contracts. The optometrists are angry because their negotiations on a new GOS contract were proceeding unremarkably when the Bill, which refers to a new contract about which they had clearly not finished consulting, was published. I know that meetings have been held and reassurances given since the Bill was published, and I think that it is now accepted that this primary legislation opportunity was taken to put the framework in place, and that the consultation will continue on what the services will involve.
	I would like to say how impressed I was by the members of the local committee whom I met that evening, and by how much they are up for improving their contribution to primary care services. They showed me what they are doing about diabetic eye screening, with the latest camera and computer technology to aid them. They told me about their joint management, with the paediatric services at the hospital, of children with visual problems. They also told me about the "red eye" service, and explained how they were developing a multi-disciplinary community approach to supporting elderly patients with failing eyesight. These are some of the remarkable provisions that they can add to our primary care services.
	I know that the great debate tonight has been about smoking, but I will say only that the Bill's proposals on that issue fit with the small contribution that I have made to the debate about primary care services. So many people in primary care services are involved in smoking cessation and in helping people to overcome their addiction to smoking, thereby preventing second-hand smoking among those of us who do not smoke. Health visitors, pharmacists, GPs and practice nurses are all involved in that same aim.
	A ban that gets us nearly to where we want to be is better than no ban at all, so I shall certainly support the proposals tonight. The right hon. Member for North-West Hampshire (Sir George Young) described how, when he joined the Administration Committee, he wanted to take the big bang approach to a total ban on selling tobacco in this place. He went on to describe how the ban was actually achieved over a number of years, a stage at a time. We will perhaps not achieve the big bang approach to a ban on this occasion, but I am sure that we will get there pretty soon.
	I see that a fixed-penalty notice scheme is being proposed for those who break the law on smoking. As I have the ear of the Minister with responsibility for public health, I should like to ask her whether she would be willing to extend that approach to a subject close to my own heart at the moment. Will she consider introducing legislation to prevent people from interfering with women who are breast-feeding in a public place? Last week, once again, we saw the scandalous situation of a man complaining to the police about a woman breast-feeding discreetly in a public place. The police sent a squad car and a uniformed officer to stop her. We will never achieve the rate of breast-feeding in this country that we see in the Scandinavian countries, with the consequent public health benefits—

Stephen Hesford: I will be in brief. In the time available, I would like to make one or two points. Some hon. Members—including the right hon. Member for Charnwood (Mr. Dorrell), the hon. Member for Tewkesbury (Mr. Robertson) and my hon. Friends the Members for Derby, North (Mr. Laxton) and for Sunderland, North (Bill Etherington)—have spoken against the ban, but I would have to characterise their speeches as disingenuous. They all failed to address the issue of the work force—precisely the point of principle at stake in the Bill.
	When my right hon. Friend opened the debate, she was right to say that a point of principle was at stake. That, indeed, is the issue that is exercising many Labour Members. I carried out a survey in my constituency and the results were similar to those that emerged from the consultation that my right hon. Friend very properly instituted after the election. In my survey, too, 90 per cent. of people wanted a ban.
	Hon. Members will recognise that we receive more letters on certain subjects than on others. I have to tell my right hon. Friend that I have received many letters on many issues during the past eight years and that a smoking ban is about the fourth most commonly raised with me. Many people have written to ask for a complete ban and I have to say that my sympathies lie with them.
	What is the point of principle? It is this: in a public health context, the Bill could be seen as a missed opportunity. It could help to transform people's lifestyle, particularly that of younger people, in a way that we want. We want to help them to lose the habit of smoking. The Government have an opportunity to use the Bill to send out a message to protect the work force and bring about, as I say, an important cultural change. It has even happened in New York of all places. Mayor Bloomberg, a Republican—not on the socialist wing of American politics—introduced a smoking ban. Similar measures have also been introduced in California, Sweden, Ireland and Norway.
	I ask my right hon. Friend and her ministerial colleagues to imagine that the House had legislated on clause 3 exemptions and stated that drinking and driving was illegal, but said, "Well, after 2 am, it will not be, because there are not many cars on the road". Imagine if we made seatbelts compulsory, except in cars whose drivers had more than 30 years' experience and a clean licence. Another parallel—[Interruption.]—I ask the House to think of the principle behind it: imagine saying that children were not allowed to work in factories, save where the factory owner had children. Some kind of sensitivity may be built into that, but I would have to point out to my right hon. Friend that the illogicality behind such thinking is stark. Similarly, if we leave the current anomaly in the Bill, we will leave those not covered by the legislation to the harmful, smoke-filled environment.
	I understand that my hon. Friend the Under-Secretary will have a difficult task in making her winding-up speech. I would like to assist her. I have with me a speech that was prepared earlier, but it is not my speech that I would like to offer her, it is the speech given by the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for St. Helens, South (Mr. Woodward) when he announced the decision on the total ban in Northern Ireland.

Andrew Murrison: The Secretary of State for Health said that this is a landmark Bill, and so it has proved for the Government. I have counted the speeches by Back Benchers today. We have had a total of 25—a remarkable effort—of which those from Labour Members for the Government counted three, but two were against, and I am honestly not clear about two others. That is something of an embarrassment for the Secretary of State.
	The right hon. Member for Rother Valley (Mr. Barron) spoke eloquently about health inequalities, a theme that ran through the debate. He specifically mentioned that 85 per cent. of pubs in Corby were likely to be exempt under the Bill and he was very concerned about the inequalities that that might engender. The hon. Member for Northavon (Steve Webb) was pressed on cannabis and he needs to construct a more cogent response. The Liberal Democrats support the Government's ban on smoking, but wish to liberalise the smoking of cannabis. I am not sure whether we heard a change of policy today, but the hon. Gentleman may wish to revisit the issue at some point.
	The right hon. Member for Holborn and St. Pancras (Frank Dobson) also talked about health inequalities and made the valid point that there is a real risk that smoking will be concentrated in those pubs that do not sell food, which risks turning such pubs into smoking dens. Like my right hon. Friend the Member for Charnwood (Mr. Dorrell), I am a liberal Conservative, but I am persuaded that the do-nothing option is untenable, given the evidence that we now have about the effects of second-hand smoke. We have to act, given the evidence that second-hand smoke causes problems. If we do not do so, we are failing our constituents. The question is how we reach the situation in which the majority of our constituents do not smoke and we reduce the incidence of lung cancer, cardiovascular disease, sudden infant death syndrome and so on.
	The hon. Member for Stoke-on-Trent, North (Joan Walley) also talked eloquently about health inequalities. Last night, my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) was with me in a pub. We were not drinking; he was smoking, but I was not. He gave a classic "cry freedom" speech, which was very stimulating. The hon. Member for Derby, North (Mr. Laxton) was the first supporter of the Government. He gave a tour de force in which he attacked the bourgeoisie and I was thrown back 50 years to a time of class warfare. If his thesis were correct, perhaps the best way to reduce health inequalities would be to increase smoking, because then the bourgeoisie would get sicker and those whom he defined as working class would get healthier. I may be confused: the hon. Gentleman certainly sounded confused in his contribution.
	My right hon. Friend the Member for North-West Hampshire (Sir George Young) made a fantastic speech that drew an important distinction between private and public spaces. He and I agreed on the Tobacco Advertising and Promotion Act 2002, when I was very new to this place, and we share a passion for reducing smoking. I certainly have that passion, both professionally and politically. The hon. Member for Liverpool, Riverside (Mrs. Ellman) rightly talked about Ireland and its experience and the lessons that we can learn. She also pointed out that 59 per cent. of pubs in Liverpool do not serve food and therefore could fall into the smoking den trap, about which many of us are concerned.
	My hon. Friend the Member for Beckenham (Mrs. Lait) talked about optical services and the other aspects of the Bill that risk being sidelined by our passion to address the smoking elements. The hon. Member for Lewisham, Deptford (Joan Ruddock) said that the Bill is unworkable, and that point was echoed by several of her colleagues.
	In bringing forward the measure, the Secretary of State has asked the House to give her more or less a blank cheque, which will allow her and her successors to fill in the important detail at leisure through regulation. I believe that the chief medical officer is relying on that blank cheque in withholding his threatened resignation. I presume that he hopes for a comprehensive ban through regulation at some point in the future.
	Although the Bill is primarily about smoking, we should not ignore its important additional features. We can agree on many of them, although we shall seek clarification and improvement in Committee. For example, why does part 3 contain no clarity over pharmacy supervision or standard operating procedures? We need the detail on how many pharmacies one person will be able to supervise. Why does part 4 apparently give PCTs carte blanche to charge pharmacists to set up new contracts? Will part 4 indeed favour larger chains at the expense of the high street, and therefore reduce choice?
	Why have ophthalmic services been bolted on to the Bill in advance of the Government's consultation on general ophthalmic services? Will the Government accept that PCTs that are strapped for cash will be tempted to degrade eye tests that they buy? To what extent will small high street opticians struggle under the new regime? Will the Minister outline the intended contents of the hospital-acquired infection code of practice? Will its benefits outweigh the cost of the yet more paperwork, tick boxes and administrative hassle that our hard-pressed professionals have to cope with? Why have the Government ignored Sir Nigel Crisp's view that target-driven high bed occupancy lies at the heart of our high MRSA rates?
	The hon. Member for Sutton and Cheam (Mr. Burstow) did not talk about smoking cannabis, but he laid into ventilation without offering any evidence when pressed. That brings me to the very good speech by the hon. Member for Sunderland, North (Bill Etherington). He is something of an expert in this sphere because he has industrial experience and is a smoker, and in his useful contribution he defenestrated the argument that ventilation has nothing to offer. It is a pity that Ministers have not at least considered the possibility that ventilation might have something to offer in all this.
	The hon. Member for Strangford (Mrs. Robinson) supported a total ban on smoking and cited international experience, particularly in the Republic of Ireland, quite rightly. The hon. Member for North-West Leicestershire (David Taylor) is a complete ban man, and brought to mind the hon. Member for Derby, North (Mr. Laxton) in his reference to King James's counterblast to tobacco.
	I am sorry that I missed some of the speech by my hon. Friend the Member for Southend, West (Mr. Amess). I understand that he spoke extremely knowledgeably about pharmacy and ophthalmology, and wondered whether either would be improved by the Bill.
	The hon. Member for Cardiff, North (Julie Morgan) asked for a free vote. The Conservative party will be offering its Members a free vote on this issue, and I call on the Minister to do her own Members the courtesy of offering the same.
	The Bill is chiefly about a smoking ban, which, in part 1 weighs most heavily on issues to do with personal choice and freedom, and has the greatest capacity to improve public health. Evidence-based public health is the only basis on which we should consider a ban. We must separate it entirely from amenity and nuisance, which are more properly dealt with elsewhere. Nowhere is the Government's conflation of nuisance with ill health more obvious than in the great play made of banning smoking within some arbitrary distance of the bar. The Government have admitted that there is no evidence that banning smoking at the bar would yield health benefits. Their consultation document referred to it as a "courtesy measure". We cannot legislate for courtesy, but we can legislate for public health. I submit that the public health argument for the red line on our carpet here in the Chamber is stronger than that for the arbitrary line that the Health Secretary wants to scratch on pub floors. At least the two swords' separation carries some logic in public health terms, and 80 per cent. of consultation respondents seemed to agree with that.
	The Government's muddle-headedness extends to the artificial distinction between pubs that serve food and pubs that do not. To be fair, the illogical association of food and smoking was made by the Health Secretary's predecessor. She may regret it—the chief medical officer certainly does—but this is her Bill and she is responsible for it. Sir Liam Donaldson is supported by the results of the Government's consultation exercise, which showed that 90 per cent. of respondents were against exempting pubs that serve food.
	Clause 4 introduces the possibility of ban on smoking in a range of outdoor places. If it is not expedient to remove a toxin by banning it, we must control exposure to it by other means. If airborne contaminants in industry settings can be removed satisfactorily using ventilation, we should not dismiss out of hand such an engineering solution in the hospitality sector, yet that is precisely what Ministers have done. Exceptions to the ban are likely to be made by the Minister. Surely an insistence on such ventilation and acceptable levels of atmospheric contamination would be both a reasonable compromise and a possible benefit to exempt establishments that may have future employee claims to defend.
	The hon. Member for Wyre Forest (Dr. Taylor) is a self-confessed anti-smoking zealot. He talked about the Clean Air Act 1956. I am pleased about that because that Act was introduced by a Conservative Government. He continued to give us a tour de force of the rest of the Bill—quite a task, given its complexity.
	The hon. Member for Thurrock (Andrew Mackinlay) is one of the two supporters of the Government that I counted—[Interruption]—in respect of the Bill, I hasten to add, and unusually so. He talked with passion about MRSA. He also told us how smoking ended the sparkling ministerial career that was otherwise surely his for the taking.
	My hon. Friend the Member for Broxbourne (Mr. Walker) made a thoughtful, passionate speech that balanced libertarianism, good sense and pragmatism. The hon. Member for Stafford (Mr. Kidney) rightly praised the extended role of pharmacists and reflected the annoyance of opticians about the appearance of clauses 34 to 40 in the midst of the consultation on general ophthalmic services.
	My hon. Friend the Member for Tewkesbury (Mr. Robertson) rightly drew our attention to the illogicalities of the Bill and the division that it has caused in the Cabinet. The hon. Member for Barnsley, East and Mexborough (Jeff Ennis) referred to raising the age of sale of tobacco to 18—an interesting concept that perhaps contrasts with the ten-minute Bill and the comments made by the hon. Member for Bristol, West (Stephen Williams) earlier today.
	My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries)—a nurse, of course—talked about MRSA and VRSA. Interestingly, the Nursing Standard pointed out on 8 March that 40 per cent. of nurses said that they did not have time to clean bed space between patients. Finally, the hon. Member for Wirral, West (Stephen Hesford) talked about drink driving.
	Tobacco is surely captain of the men of death. I spent 20 years trying to persuade people to stop smoking. As a politician, I had rather hoped to have a Bill that would be more likely to address smoking than this one. It is a missed opportunity. My hon. Friends will use their judgment and will vote freely. I hope the Minister will allow Labour Members to have a free vote, too.

Petitions
	 — 
	BUPA CARE SERVICES

David Taylor: I am happy for my hon. Friend to do that. I know that he has recently asked questions about the future of the MRS.
	Those Members are rightly proud of, and reassured by, their constituencies being bases for the MRS, and have consistently lobbied the Government on its behalf.
	So what of the future? Industrial accidents of the awful scale seen yesterday at the Dongfeng mine in north-east China may be regarded as a thing of the past in this country, but the skills, knowledge and expertise developed first by the British Coal Corporation and continued by the MRS have the potential to be of crucial benefit in a wide range of disastrous circumstances in many parts of the world.
	Our industrial history has bequeathed us an exceptional search and rescue service that we risk losing at a time when we face a distinct threat from our past—international terrorism. That is most likely to strike in urban areas, as the appalling events in parts of London on 7 July this year tragically confirmed, and the MRS is the only organisation adapted purely to the needs of emergency search, rescue and escape situations. We cannot afford to lose those skills at this time.
	We have come a long way since the heroic efforts of Charles Clamp and the many other miners who perished trying to save lives that some pit owners disdained as mere numbers. I hope that we will hear some recognition from the Minister of the Government's duty to recognise the past legacy, current value and future potential represented by the MRS. Some companies appoint themselves to a tier of the emergency services in their advertising. The MRS can legitimately claim that through its training and development of a growing number of fire and rescue service staff across the UK. As my hon. Friend the Member for Elmet said, that suggests a continued public sector involvement. No fanfare is required, just Government funding to meet the present shortfall if we are to continue to benefit in the medium term from the skills, courage and professionalism of the MRS, to which all Members here would pay tribute.

Gerry Sutcliffe: I congratulate my hon. Friend the Member for North-West Leicestershire (David Taylor) on securing an important debate. I thank him, my right hon. Friend the Member for Rother Valley (Mr. Barron) and my hon. Friends the Members for Mansfield (Mr. Meale) for Elmet (Colin Burgon) and for Houghton and Washington, East (Mr. Kemp) for their contributions. I also thank my hon. Friend the Member for North-West Leicestershire for understanding why my hon. Friend the Minister for Energy is not replying to the debate.
	It goes without saying that underground coal and other mining operations take place in highly hazardous conditions. A fire or explosion underground can produce large quantities of carbon monoxide and other noxious gases. Old workings and mine waste can release asphyxiating fumes. Serious machinery or transport accidents can also occur. However, for me, the most harrowing possibility is a roof fall that leaves miners trapped underground, perhaps miles from the safety of the pithead.
	Despite those ever-present dangers, I am glad to say that the coal mining industry's recent safety record in this country is excellent. There has been one fatality this millennium and only 53 major injuries occurred in 2004–05. Of course, that neither detracts from the fact that it is vital for mine operators to have access to the specialist underground rescue services to respond to emergencies on the thankfully rare occasions that they occur nor from the courage and dedication of those whose business is to provide those services.
	In the United Kingdom, local authority emergency services generally deal with fires, explosions and gas leaks on the surface in residential, commercial and industrial premises. However, they do not have the specialist skills and experience necessary to cope with underground emergencies, which require specialised breathing apparatus and other equipment, and important specialist training.
	Mines rescue services are principally relevant to the deep-mine coal industry. However, other underground mines such as salt, gypsum, stone, potash and storage mines may also use them. In addition, their services may on occasion be called upon to rescue members of the public from abandoned mine workings, culverts and confined spaces.
	Against that background, the Escape and Rescue from Mines Regulations 1995 provide the current legislative framework for mines rescue in the UK. Under the regulations, owners of all types of mine must make what are termed "effective arrangements" for the rescue of persons operating below ground. However, the owners of coal mines in particular must ensure that sufficient trained and fully equipped rescue team members are available as required to provide a continuous 24-hour rescue service. To that end, coal mine operators must participate in a Government-approved mines rescue scheme.
	The scheme requires: the maintenance of an adequate pool of full and part-time rescue workers; the operation of a common command structure with suitably qualified and competent rescue offices to supervise the training and operation of rescue teams; the maintenance of regional mines rescue stations at suitable locations, with common communication systems; suitable equipment that is common throughout the country; similar training for all rescue personnel, and the co-ordination of arrangements for mutual assistance between members in an emergency situation at any member's mine.
	As we all know, privatisation of the coal mining industry in 1994 led to the creation of several new deep-mine owners. In the 1993 White Paper "The Prospects for Coal", the Government of the day clearly reaffirmed a commitment to ensuring that health and safety standards would be maintained after privatisation. The document states:
	"Safety must, of course, continue to be paramount. The Government is determined to ensure, in consultation with the Health and Safety Commission, who remain responsible for safety regulation in the industry, that the existing high safety standards in such mines are maintained after they pass into the private sector."
	The maintenance of effective mines rescue provision clearly was, and continues to be a vital part of that equation.
	For a period following its effective withdrawal from mining, British Coal provided to its successor deep-mine operators a fully trained mines rescue service, which, at the time, numbered around 100 full-time and 500 part-time rescue workers. In 1996, the assets, employees and liabilities of British Coal's mines rescue operation were transferred to a stand-alone company. Mines Rescue Service Ltd has fulfilled the requirements of the statutory scheme ever since.
	As my hon. Friend the Member for North-West Leicestershire said, Mines Rescue Service Ltd operates from headquarters in Mansfield in Nottinghamshire and from a network of rescue stations in the proximity of the remaining deep mines, whose operators, principally UK Coal and Tower colliery, finance the service by means of a production levy, currently standing at 16p per tonne.
	In 2002, the Health and Safety Executive commissioned an examination of alternative structures for the provision of mines rescue arrangements in Great Britain and to assess their relative merits against credible scenarios for the future coal mining industry. The resultant report concluded that, from a structural perspective, the existing arrangements provided the most flexible and lowest cost means of ensuring rescue cover to both large and small mine operators.
	However, it would be remiss of me if I did not acknowledge that, in examining the funding aspects of the service, the 2002 report propounded several alternatives to the status quo, recognising the further contraction in the industry that had taken place since the service's creation. It suggested that there were cogent arguments for partial or total Government funding. In doing so, it noted that, in other countries with active deep- mine coal industries, Governments provided funding or at least a subsidy. International comparisons suggested that it was common for operators to contribute to the funding of mines rescue provision up to a specified limit, and for the balance to be met centrally. Such a system obviously provides operators with greater certainty that they will be insulated against cost escalation.
	We were sufficiently persuaded by the case for Government assistance when, in 2003, we were considering how best to formulate a package of support for the coal sector. The principal element of what emerged was, of course, the coal investment aid scheme, from which we have awarded more than £58 million to deep-mine projects. At the same time, we pledged to endeavour to provide funding for the MRS over the three-year period from 2003 to 2006. However, finding those funds was always going to be an uphill struggle. None the less, I am glad to say that last year and the year before, our efforts were successful, thanks to the Coal Authority.
	The authority, as most hon. Members will know, is the industry's licensing body and the inheritor of much of the environmental legacy of past mining. Some of its functions are self-financing but, for the others, it receives grant-in-aid funding from my Department. As well as inheriting a raft of liabilities, the authority was heir to a good deal of former British Coal land and property, and it has been disposing of this over the years. In both 2003–04 and 2004–05, we allowed the authority to direct windfall gains on property sales towards the MRS. The £2.5 million paid in each of those years enabled the service to reimburse deep-mine operators for the levy payments that they had made over the period. Regrettably, however, it looks highly unlikely that we will be in a position to repeat the process this year or in the future.